CPT code 01925 is used for anesthesia services during therapeutic interventional radiological procedures on the cardiovascular system.
CPT code 01925 is used to describe anesthesia services provided for therapeutic interventional radiological procedures on the heart. This code is specifically utilized when anesthesia is administered to a patient undergoing a radiological intervention aimed at treating cardiac conditions. Such procedures may include, but are not limited to, catheter-based interventions or other minimally invasive techniques that require precise imaging guidance. The use of this code ensures that the anesthesia services are accurately documented and billed, reflecting the specialized nature of the care provided during these complex cardiac interventions.
For CPT code 01925, which pertains to anesthesia for therapeutic interventional radiological procedures on the heart, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the anesthesia service provided was significantly greater than typically required. Documentation must support the substantial additional work and time involved.
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): If the surgeon administers the anesthesia, this modifier is used to indicate that the anesthesia service was provided by the surgeon themselves.
4. Modifier 59 (Distinct Procedural Service): Use this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is particularly relevant if multiple procedures are performed and need to be separately identified.
5. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used when the same procedure is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure.
6. Modifier 77 (Repeat Procedure by Another Physician): Use this modifier when a procedure is repeated by a different physician or qualified healthcare professional.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room): This modifier is applicable if the 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): Use this modifier when an unrelated procedure or service is performed by the same physician during the postoperative period.
9. Modifier AA (Anesthesia Services Performed Personally by Anesthesiologist): This modifier indicates that the anesthesia services were personally performed by an anesthesiologist.
10. Modifier QK (Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures): Use this modifier 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 the service provided was monitored anesthesia care.
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 CRNA by an Anesthesiologist): Use this modifier 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.
Each modifier serves a specific purpose and should be used according to the specific circumstances of the anesthesia service provided. Proper documentation is essential to support the use of any modifier.
CPT code 01925 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. Whether CPT code 01925 is reimbursed by Medicare depends on several factors, including its inclusion in the MPFS and any specific guidelines or coverage determinations made by the Medicare Administrative Contractor (MAC) for the region where the service is provided.
Each MAC has the authority to interpret national policies and make local coverage determinations (LCDs) that can affect the reimbursement of specific CPT codes. Therefore, it is crucial for healthcare providers to consult the relevant MAC's guidelines and the MPFS to determine if CPT code 01925 is reimbursed in their specific jurisdiction. Additionally, providers should ensure that all documentation and billing practices align with Medicare's requirements to facilitate proper reimbursement.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 01925, RevFind offers unparalleled accuracy in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and optimize your financial outcomes.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
