CPT code 01756 is used for anesthesia services during radical surgery on the humerus, ensuring accurate procedure documentation.
CPT code 01756 is used to describe the anesthesia services provided during a radical surgical procedure on the humerus, which is the long bone in the upper arm. This code is specifically utilized by anesthesiologists or anesthesia providers to document and bill for the administration of anesthesia during such complex surgeries. The procedure typically involves extensive surgical intervention on the humerus, often due to conditions like tumors or severe fractures, requiring specialized anesthesia care to ensure patient safety and comfort throughout the operation.
For CPT code 01756, which pertains to anesthesia services for radical surgery on the humerus, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide the service is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 23 - Unusual Anesthesia: This modifier is applicable when a procedure that usually requires no anesthesia or local anesthesia must be performed under general anesthesia due to unusual circumstances.
3. Modifier 47 - Anesthesia by Surgeon: This is used when the surgeon administers regional or general anesthesia to the patient. It is not used for local anesthesia.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used when a patient requires a return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure or service performed during the postoperative period is unrelated to the original procedure.
9. Modifier AA - Anesthesia Services Performed Personally by Anesthesiologist: This modifier is used to indicate that the anesthesia services were personally performed by an anesthesiologist.
10. Modifier QK - Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures Involving Qualified Individuals: This is used when an anesthesiologist is medically directing two to four concurrent anesthesia procedures.
11. Modifier QS - Monitored Anesthesia Care Service: This modifier is used to indicate that monitored anesthesia care (MAC) was provided.
12. Modifier QX - CRNA Service: With Medical Direction by a Physician: This modifier is used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
13. Modifier QY - Medical Direction of One Certified Registered Nurse Anesthetist (CRNA) by an Anesthesiologist: This is used when an anesthesiologist provides medical direction for one CRNA.
14. Modifier QZ - CRNA Service: Without Medical Direction by a Physician: This modifier is used when a CRNA provides anesthesia services without the medical direction of a physician.
These modifiers help in accurately reporting the circumstances under which anesthesia services are provided, ensuring appropriate billing and reimbursement. Proper documentation is essential to support the use of these modifiers.
CPT code 01756 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service. However, the actual reimbursement for CPT code 01756 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting local coverage determinations, which can influence whether and how much Medicare reimburses for this specific CPT code. Therefore, healthcare providers should consult their respective MAC for detailed information on reimbursement rates and any additional requirements for CPT code 01756.
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