CPT code 01958 is used for anesthesia services during antepartum manipulation procedures, ensuring accurate documentation and reimbursement.
CPT code 01958 is used to describe anesthesia services provided for antepartum manipulation procedures. This code is specifically applied when anesthesia is administered to a patient undergoing a procedure to manipulate the fetus before childbirth, typically to correct fetal position or address other prenatal concerns. The use of this code ensures that the anesthesia services are accurately documented and billed, reflecting the specialized care provided during such prenatal interventions.
For CPT code 01958, which pertains to anesthesia services for antepartum manipulation, 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 anesthesia service involved additional complexity or time.
2. Modifier 23 (Unusual Anesthesia): Applied 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 if the surgeon administers the regional or general anesthesia. This is rare but applicable 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 relevant if multiple procedures are performed and need to be separately identified.
5. Modifier AA (Anesthesia Services Performed Personally by Anesthesiologist): Indicates that the anesthesiologist personally performed the anesthesia service.
6. Modifier AD (Medical Supervision by a Physician: More than Four Concurrent Anesthesia Procedures): Used when an anesthesiologist supervises more than four concurrent anesthesia procedures.
7. Modifier QK (Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures Involving Qualified Individuals): Indicates medical direction by an anesthesiologist for multiple procedures.
8. Modifier QS (Monitored Anesthesia Care Service): Used to report monitored anesthesia care services.
9. Modifier QX (CRNA Service: With Medical Direction by a Physician): Indicates that a Certified Registered Nurse Anesthetist (CRNA) provided the service under the medical direction of a physician.
10. Modifier QY (Medical Direction of One CRNA by an Anesthesiologist): Used when an anesthesiologist provides medical direction for one CRNA.
11. Modifier QZ (CRNA Service: Without Medical Direction by a Physician): Indicates that a CRNA provided the service 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.
The CPT code 01958 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by the Medicare Administrative Contractor (MAC) for your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for services, including anesthesia services.
However, the final determination of whether CPT code 01958 is reimbursed can vary based on local coverage determinations (LCDs) and specific billing guidelines established by the MAC.
It is essential for healthcare providers to verify the reimbursement status of CPT code 01958 with their regional MAC to ensure compliance and accurate billing practices.
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