CPT code 11983 is for the removal and insertion of a drug implant, commonly used in various medical treatments.
CPT code 11983 is used to describe the medical procedure for the removal and insertion of a drug implant. This code is typically utilized when a healthcare provider needs to take out an existing drug implant and replace it with a new one. Drug implants are often used for long-term medication delivery, such as hormonal treatments or pain management. This code ensures that the provider is accurately reimbursed for both the removal of the old implant and the insertion of the new one in a single procedure.
For CPT code 11983 (Remove/insert drug implant), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more effort or time than typically required.
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 procedure 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 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 a procedure or service 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 procedure was repeated by the same physician or other qualified healthcare professional.
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 or other qualified healthcare professional.
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 required an unplanned 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 or service was performed by the same physician during the postoperative period.
12. Modifier 80 - Assistant Surgeon
- Apply this modifier if an assistant surgeon was required during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier if a minimum assistant surgeon was required during the procedure.
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 service provided.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 11983, which involves the removal and insertion of a drug implant, 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 local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 11983.
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