CPT code 01926 is used for anesthesia services during therapeutic interventional radiology procedures involving the heart or cranium.
CPT code 01926 is used to describe anesthesia services provided during therapeutic interventional radiological procedures involving the heart or cranium. This code is specifically designated for anesthesia care that supports complex interventions in these critical areas, ensuring patient comfort and safety during procedures that may involve catheter-based treatments or other minimally invasive techniques targeting the heart or brain.
For CPT code 01926, which pertains to anesthesia services for therapeutic interventions in the heart or cranial area, 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. It may be applicable if the anesthesia service for the procedure was more complex or time-consuming than usual.
2. Modifier 23 - Unusual Anesthesia: This modifier 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 used when the surgeon administers regional or general anesthesia to the patient. It is not applicable for anesthesia codes but may be relevant if the surgical procedure is billed separately.
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 may be necessary 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. It may be applicable if the anesthesia service is repeated within a short timeframe.
6. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician. It may be relevant if another anesthesiologist provides the service in a subsequent session.
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 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 During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
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 modifier is used when an anesthesiologist is directing multiple anesthesia procedures concurrently.
11. Modifier QS - Monitored Anesthesia Care Service: This modifier is used to indicate that monitored anesthesia care 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 CRNA by an Anesthesiologist: This modifier is used when an anesthesiologist provides medical direction for a single 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 provide additional information about the anesthesia services rendered and ensure accurate billing and reimbursement. It's important to select the appropriate modifiers based on the specific circumstances of the procedure.
The CPT code 01926 is subject to reimbursement by Medicare, but its reimbursement status depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) in your region. The MPFS provides a list of services and their corresponding reimbursement rates, which are updated annually. To determine if CPT code 01926 is reimbursed, healthcare providers should consult the MPFS for the current year to verify its status and reimbursement rate.
Additionally, MACs, which are regional contractors that process Medicare claims, may have specific local coverage determinations (LCDs) that affect the reimbursement of certain CPT codes. Therefore, it is crucial for providers to check with their local MAC to ensure compliance with any regional policies or requirements that might impact the reimbursement of CPT code 01926.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 01926, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can identify discrepancies by individual payer and enhance your revenue cycle management.
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
