CPT code 01966 is used for anesthesia services during induced abortion procedures, ensuring accurate documentation and reimbursement.
CPT code 01966 is used to describe anesthesia services provided for a procedure involving the induction of labor. This code is specifically utilized when anesthesia is administered to a patient undergoing an induced labor process, which is a medical procedure to stimulate uterine contractions before natural labor begins. The code ensures that the anesthesia provider is accurately reimbursed for their role in managing the patient's pain and comfort during this specific type of obstetric procedure.
For CPT code 01966, which pertains to anesthesia services for certain procedures, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide the service is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 23 - Unusual Anesthesia: This modifier is 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: This is used when the surgeon administers regional or general anesthesia to the patient. It is not applicable for local anesthesia.
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. It is used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This is used when a procedure or service is repeated by the same provider subsequent to the original procedure or service.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This is used when a procedure or service is repeated by a different provider subsequent to the original procedure or service.
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: This is used when a patient requires a return 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 is used when a procedure performed during the postoperative period is unrelated to the original procedure.
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: This is used when an anesthesiologist is directing multiple anesthesia procedures.
11. Modifier QS - Monitored Anesthesia Care Service: This indicates that the service provided was monitored anesthesia care.
12. Modifier QX - CRNA Service: With Medical Direction by a Physician: This is 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: This is used when an anesthesiologist provides medical direction for one CRNA.
14. Modifier QZ - CRNA Service: Without Medical Direction by a Physician: This is used when a CRNA provides anesthesia services without the medical direction of a physician.
These modifiers are used to provide additional information about the circumstances under which the anesthesia service was provided, ensuring accurate billing and reimbursement. Proper documentation is essential to support the use of these modifiers.
CPT code 01966 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 01966 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting local coverage determinations, which can influence whether and how much Medicare reimburses for this particular code. Therefore, healthcare providers should consult their specific MAC for detailed information on reimbursement rates and any additional requirements for CPT code 01966.
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