CPT code 01935 is used for anesthesia services during diagnostic imaging procedures involving the spine.
CPT code 01935 is used to describe anesthesia services provided for percutaneous image-guided diagnostic spine procedures. This code is specifically applied when anesthesia is administered to a patient undergoing a minimally invasive procedure on the spine, where imaging techniques such as fluoroscopy, CT, or ultrasound are used to guide the diagnostic process. The purpose of this code is to ensure accurate billing and documentation of the anesthesia services associated with these specialized diagnostic procedures, which are often performed to identify or assess spinal conditions.
For CPT code 01935, which pertains to anesthesia for percutaneous image-guided diagnostic or therapeutic procedures on the spine or spinal cord, 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 the reason for it.
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): If the surgeon administers regional or general anesthesia, this modifier is applicable. It is not used for local anesthesia.
4. Modifier 59 (Distinct Procedural Service): Apply this modifier when the anesthesia service is distinct or independent from other services performed on the same day. It indicates that the service is not part of a bundled procedure.
5. Modifier 76 (Repeat Procedure by Same Physician): Use this modifier if the same physician repeats the procedure on the same day.
6. Modifier 77 (Repeat Procedure by Another Physician): This is applicable when a different physician repeats the procedure on the same day.
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): Use this 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 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): Use this when an anesthesiologist is directing multiple anesthesia procedures.
11. Modifier QS (Monitored Anesthesia Care Service): This 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 the service under the medical direction of a physician.
13. Modifier QY (Medical Direction of One CRNA by an Anesthesiologist): Use this when an anesthesiologist provides medical direction for one CRNA.
14. Modifier QZ (CRNA Service without Medical Direction by a Physician): This is applicable when a CRNA provides the service without the medical direction of a physician.
Each modifier serves a specific purpose and should be used in accordance with the documentation and circumstances surrounding the anesthesia service provided. Proper use of modifiers ensures accurate billing and reimbursement.
The CPT code 01935 is reimbursed by Medicare, but its reimbursement is subject to specific conditions 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 01935 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for interpreting national Medicare policies and setting local coverage determinations, which can affect whether and how much a particular service is reimbursed. Therefore, healthcare providers should consult their local MAC for precise reimbursement details for CPT code 01935.
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