CPT code 01952 is used for anesthesia services provided during the treatment of burns covering 4-9% of the body surface area.
CPT code 01952 is used to describe anesthesia services provided for burn excisions or debridement procedures involving 4 to 9 percent of total body surface area. This code is specifically utilized by anesthesiologists or anesthesia providers to document and bill for the administration of anesthesia during these types of surgical interventions. The code helps ensure accurate billing and reimbursement by reflecting the complexity and extent of the anesthesia service required for treating burns within this specified range of body surface area.
For CPT code 01952, which pertains to anesthesia services for burn excisions or debridement covering 4-9 percent of total body surface area, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Used when the work required to provide the service is substantially greater than typically required. This could apply if the burn area is particularly complex or if there are complications during the procedure.
2. Modifier 23 (Unusual Anesthesia): 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): Used when the surgeon administers regional or general anesthesia to the patient. This is not typically used for anesthesia codes but may be relevant in specific scenarios.
4. Modifier 59 (Distinct Procedural Service): Indicates that a procedure or service was distinct or independent from other services performed on the same day. This might be used if multiple procedures are performed that are not typically reported together.
5. Modifier 76 (Repeat Procedure by Same Physician): Used if the same procedure is repeated by the same physician on the same day.
6. Modifier 77 (Repeat Procedure by Another Physician): Used if the same procedure is repeated by a different physician on the same day.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room): Used for an unplanned return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician): Used for an unrelated procedure or service by the same physician during the postoperative period.
9. Modifier AA (Anesthesia Services Performed Personally by Anesthesiologist): Indicates that the anesthesiologist personally performed the anesthesia service.
10. Modifier QK (Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures): Used when an anesthesiologist is directing multiple anesthesia procedures concurrently.
11. Modifier QS (Monitored Anesthesia Care Service): Indicates that monitored anesthesia care was provided.
12. Modifier QX (CRNA Service with Medical Direction by a Physician): 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): Indicates that an anesthesiologist is providing medical direction for one CRNA.
14. Modifier QZ (CRNA Service without Medical Direction by a Physician): Used when a CRNA provides anesthesia services without the medical direction of a physician.
These modifiers help provide additional information about the circumstances under which the anesthesia service was provided, ensuring accurate billing and reimbursement.
CPT code 01952, which is related to anesthesia services, is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates.
However, the actual reimbursement for CPT code 01952 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret national Medicare policies and apply them to local circumstances, which can affect the reimbursement process.
Therefore, healthcare providers should consult their specific MAC for detailed information on the reimbursement rates and any additional requirements for CPT code 01952.
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