CPT code 01942 is used for anesthesia services during procedures on the lumbar or sacral spine involving neuromodulation or neurovertebral interventions.
CPT code 01942 is used to describe anesthesia services provided for procedures involving the neuromodulation or intervention of the lumbar or sacral spine. This code is specifically utilized when an anesthesiologist administers anesthesia to a patient undergoing surgical or diagnostic procedures targeting the lumbar or sacral regions of the spine, which are part of the lower back. The code ensures that the anesthesia services are accurately documented and billed, reflecting the specialized care required for such spinal interventions.
For CPT code 01942, which pertains to anesthesia services for procedures on the lumbar or sacral spine, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the anesthesia service provided was significantly more complex or required more time than usual.
2. Modifier 23 (Unusual Anesthesia): This modifier is applicable when a procedure that typically does not require anesthesia or requires local anesthesia necessitates general anesthesia due to unusual circumstances.
3. Modifier 47 (Anesthesia by Surgeon): If the surgeon administers the anesthesia, this modifier should be used to indicate that the anesthesia was not provided by an anesthesiologist.
4. Modifier 59 (Distinct Procedural Service): Use this modifier to indicate that the anesthesia service was distinct or independent from other services performed on the same day.
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): Applicable when an anesthesiologist is directing multiple anesthesia procedures simultaneously.
7. Modifier QX (CRNA Service with Medical Direction by a Physician): Use this modifier when a Certified Registered Nurse Anesthetist (CRNA) provides the service under the medical direction of a physician.
8. Modifier QY (Medical Direction of One CRNA by an Anesthesiologist): This modifier is used when an anesthesiologist provides medical direction for a single CRNA.
9. Modifier QZ (CRNA Service without Medical Direction by a Physician): Applicable when a CRNA provides anesthesia services without the medical direction of a physician.
10. Modifier P1-P6 (Physical Status Modifiers): These modifiers indicate the patient's physical status and range from P1 (a normal healthy patient) to P6 (a declared brain-dead patient whose organs are being removed for donor purposes).
Each of these modifiers serves a specific purpose and should be used according to the specific circumstances of the anesthesia service provided. Proper use of modifiers ensures accurate billing and reimbursement for anesthesia services.
CPT code 01942 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 pay doctors or other providers/suppliers. Whether CPT code 01942 is reimbursed by Medicare depends on several factors, including its inclusion in the MPFS and any local coverage determinations made by the Medicare Administrative Contractor (MAC) responsible for the geographic area where the service is provided.
Each MAC has the authority to make decisions regarding the coverage and reimbursement of specific CPT codes based on local needs and policies. Therefore, while CPT code 01942 may be listed in the MPFS, its reimbursement is ultimately determined by the MAC's guidelines and any applicable national or local coverage determinations. Providers should consult the specific MAC for their region to confirm the reimbursement status of CPT code 01942 and ensure compliance with any additional documentation or billing requirements.
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