CPT code 11977 is for the removal and reinsertion of a contraceptive capsule, used in medical billing to describe this specific procedure.
CPT code 11977 is used for the removal and reinsertion of a contraceptive capsule. This code is typically utilized when a healthcare provider needs to take out an existing contraceptive implant and replace it with a new one during the same visit. This procedure is often performed to ensure continued contraceptive effectiveness or to address any issues with the current implant.
For CPT code 11977, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. This modifier is used if an E/M service is provided on the same day as the procedure and is distinct from the procedure itself.
2. Modifier 50: Bilateral procedure. This modifier is used if the procedure is performed on both sides of the body.
3. Modifier 51: Multiple procedures. This modifier is used when multiple procedures are performed during the same session by the same provider.
4. Modifier 52: Reduced services. This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53: Discontinued procedure. This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. 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.
7. Modifier 76: Repeat procedure or service by the same physician or other qualified health care professional. This modifier is used when a procedure or service is repeated by the same provider.
8. Modifier 77: Repeat procedure by another physician or other qualified health care professional. This modifier is used when a procedure or service is repeated by a different provider.
9. 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 modifier is used when a related procedure is performed during the postoperative period of the initial procedure.
10. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. This modifier is used when an unrelated procedure is performed during the postoperative period of the initial procedure.
11. Modifier 80: Assistant surgeon. This modifier is used when an assistant surgeon is required for the procedure.
12. Modifier 81: Minimum assistant surgeon. This modifier is used when a minimum assistant surgeon is required for the procedure.
13. Modifier 82: Assistant surgeon (when qualified resident surgeon not available). This modifier is used when an assistant surgeon is required and a qualified resident surgeon is not available.
14. Modifier 91: Repeat clinical diagnostic laboratory test. This modifier is used when a clinical diagnostic laboratory test is repeated.
15. Modifier 99: Multiple modifiers. This modifier is used when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 11977 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, it is advisable to consult with your local Medicare Administrative Contractor (MAC) to confirm any regional variations or specific guidelines that may apply to the reimbursement of CPT code 11977. Each MAC may have unique policies or requirements that could impact the reimbursement process.
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