CPT code 01758 is used for anesthesia services during surgery on a humeral lesion, ensuring accurate procedure documentation and reimbursement.
CPT code 01758 is used to describe the anesthesia services provided during surgical procedures on the humeral lesion. This code is specifically designated for the administration of anesthesia to a patient undergoing surgery to address a lesion located on the humerus, which is the long bone in the upper arm. The code ensures that the anesthesia services are accurately documented and billed, reflecting the complexity and specific nature of the procedure being performed.
For CPT code 01758, which pertains to anesthesia services for surgical procedures on the humeral lesion, 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. This could be due to unusual procedural complications or patient conditions.
2. Modifier 23 - Unusual Anesthesia: This is used 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 modifier is applicable if the surgeon administers regional or general anesthesia to the patient.
4. Modifier 59 - Distinct Procedural Service: This is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same physician repeats a procedure or service.
6. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure or service is repeated by a different physician.
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 is used when a patient returns 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 is used when a procedure or service is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
9. Modifier AA - Anesthesia Services Performed Personally by Anesthesiologist: This indicates that the anesthesiologist personally performed the anesthesia service.
10. Modifier QK - Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures Involving Qualified Individuals: This is used when an anesthesiologist is directing multiple anesthesia procedures.
11. Modifier QS - Monitored Anesthesia Care Service: This indicates that the service provided was monitored anesthesia care.
12. Modifier QX - CRNA Service with Medical Direction by a Physician: This is used when a Certified Registered Nurse Anesthetist (CRNA) provides the service under the direction of a physician.
13. Modifier QY - Medical Direction of One CRNA by an Anesthesiologist: This indicates that an anesthesiologist is directing a single CRNA.
14. Modifier QZ - CRNA Service without Medical Direction by a Physician: This is used when a CRNA provides the service without physician direction.
These modifiers help provide additional information about the circumstances under which the anesthesia service was provided, ensuring accurate billing and reimbursement.
The CPT code 01758 is reimbursed by Medicare, but its reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of fees that Medicare uses to reimburse healthcare providers for services rendered. However, the actual reimbursement for CPT code 01758 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret national policies and establish local coverage determinations, which can influence whether and how much a particular service is reimbursed. Therefore, it is essential for healthcare providers to consult with their respective MAC to understand the specific reimbursement details for CPT code 01758 in their region.
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