CPT code 01953 is used for anesthesia services provided for burn treatment covering each additional 9% of body surface area.
CPT code 01953 is used to describe anesthesia services provided for burn excisions or debridement procedures. Specifically, it applies to anesthesia administered for each additional 9 percent of total body surface area (TBSA) that is treated. This code is typically used in cases where patients with extensive burns require surgical intervention, and the anesthesia provider needs to account for the complexity and duration of the procedure based on the extent of the burns being addressed.
For CPT code 01953, which pertains to anesthesia services for burn excisions or debridement, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. For example, if the anesthesia service for burn treatment is more complex due to the extent or severity of the burns, Modifier 22 may be appropriate.
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. If the burn treatment necessitates general anesthesia unexpectedly, Modifier 23 could be applied.
3. Modifier 47 - Anesthesia by Surgeon: If the surgeon administers the anesthesia themselves, Modifier 47 is used to indicate this scenario.
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. If multiple distinct anesthesia services are provided, Modifier 59 may be necessary.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: If the anesthesia service for burn treatment is repeated on the same day by the same provider, Modifier 76 should be used.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: If the anesthesia service is repeated on the same day by a different provider, Modifier 77 is applicable.
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: If the patient requires an unplanned return to the operating room for additional burn treatment, Modifier 78 may be used.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If a new, unrelated procedure requiring anesthesia is performed during the postoperative period, Modifier 79 is appropriate.
9. Modifier AA - Anesthesia Services Performed Personally by Anesthesiologist: This modifier is used when the anesthesiologist personally performs the anesthesia service.
10. Modifier QK - Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures Involving Qualified Individuals: If the anesthesiologist is directing multiple anesthesia services concurrently, Modifier QK is used.
11. Modifier QS - Monitored Anesthesia Care Service: This modifier indicates that monitored anesthesia care (MAC) was provided.
12. Modifier QX - CRNA Service: With Medical Direction by a Physician: 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: This modifier is used when an anesthesiologist provides 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 services were provided, ensuring accurate billing and reimbursement.
CPT code 01953 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, along with the payment rates for each service. However, the actual reimbursement for CPT code 01953 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 criteria and rates applicable to CPT code 01953.
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