CPT code 11982 is used for the removal of a drug implant device, ensuring accurate billing and documentation in healthcare services.
CPT code 11982 is used to describe the procedure for removing a drug implant device from a patient. This code is typically utilized when a healthcare provider needs to extract a previously implanted device that was used to deliver medication over a period of time. The removal process involves careful extraction to ensure that the surrounding tissues are not damaged and that the device is fully retrieved. This code is essential for accurate billing and documentation of the procedure within the healthcare revenue cycle.
When dealing with CPT code 11982 for the removal of a drug implant device, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers and the reasons for their use:
1. Modifier 22 (Increased Procedural Services)
- Use this modifier if the procedure required significantly more effort or time than usual due to complications or other factors.
2. Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service)
- Apply this modifier if a significant, separately identifiable E/M service was performed by the same physician on the same day as the procedure.
3. Modifier 50 (Bilateral Procedure)
- Use this modifier if the removal of drug implant devices was performed bilaterally.
4. Modifier 51 (Multiple Procedures)
- Apply this modifier if multiple procedures were performed during the same session.
5. Modifier 52 (Reduced Services)
- Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
6. Modifier 53 (Discontinued Procedure)
- Apply this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threatened the well-being of the patient.
7. Modifier 59 (Distinct Procedural Service)
- Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
8. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional)
- Apply this modifier if the same procedure was repeated by the same physician.
9. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional)
- Use this modifier if the procedure was repeated by a different physician.
10. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period)
- Apply this modifier if the patient had to return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period)
- Use this modifier if an unrelated procedure was performed by the same physician during the postoperative period.
12. Modifier 80 (Assistant Surgeon)
- Apply this modifier if an assistant surgeon was necessary for the procedure.
13. Modifier 81 (Minimum Assistant Surgeon)
- Use this modifier if a minimum assistant surgeon was required.
14. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available))
- Apply this modifier if an assistant surgeon was required because a qualified resident surgeon was not available.
15. Modifier 99 (Multiple Modifiers)
- Use this modifier if multiple modifiers are necessary to describe the procedure accurately.
Each of these modifiers serves a specific purpose and should be used to provide additional information about the circumstances under which CPT code 11982 was performed. Proper use of these modifiers ensures accurate billing and reimbursement.
The CPT code 11982, which involves the removal of a drug implant device, is reimbursed by Medicare. To determine the specific reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for various services covered by Medicare. Additionally, it is important to consult with your regional Medicare Administrative Contractor (MAC) for any specific guidelines or variations in reimbursement policies that may apply to your locality. The MAC is responsible for processing Medicare claims and can provide further clarification on coverage and payment details for CPT code 11982.
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