CPT code 01931 is used for anesthesia services during therapeutic interventional radiology procedures, specifically for transjugular intrahepatic portosystemic shunt (TIPS).
CPT code 01931 is used to describe anesthesia services provided during therapeutic interventional radiological procedures involving transjugular intrahepatic portosystemic shunt (TIPS). This code is specifically for the anesthesia care required when a patient undergoes a TIPS procedure, which is a technique used to create a pathway within the liver to reduce portal hypertension and manage complications such as variceal bleeding or ascites. The anesthesia provider ensures the patient is safely sedated and monitored throughout the procedure, allowing the interventional radiologist to perform the necessary interventions.
For CPT code 01931, which pertains to anesthesia services for therapeutic interventional radiological procedures, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. It may be applicable if the anesthesia services for the procedure were 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 typically used for anesthesia codes but may be relevant in specific scenarios.
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 AA - Anesthesia Services Performed Personally by Anesthesiologist: This modifier is used when the anesthesiologist personally performs the anesthesia service.
6. Modifier QK - Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures: This modifier is used when an anesthesiologist is medically directing two to four concurrent anesthesia procedures.
7. Modifier QS - Monitored Anesthesia Care Service: This modifier is used to indicate that monitored anesthesia care (MAC) was provided.
8. 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.
9. Modifier QY - Medical Direction of One CRNA by an Anesthesiologist: This modifier is used when an anesthesiologist provides medical direction for a single CRNA.
10. 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 is important to select the appropriate modifiers based on the specific details of the procedure and the role of the anesthesia provider.
CPT code 01931 is related to anesthesia services and its reimbursement by Medicare is determined by several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the policies of the local Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of services covered by Medicare, along with their respective reimbursement rates. However, whether CPT code 01931 is reimbursed can also depend on the specific guidelines and coverage determinations set forth by the MAC in your region.
Each MAC has the authority to interpret national policies and establish local coverage decisions, which can influence whether a particular CPT code is reimbursed. Therefore, to confirm if CPT code 01931 is reimbursed by Medicare, it is advisable to consult the MPFS and reach out to your local MAC for the most accurate and region-specific information.
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