CPT code 19272 is used for billing extensive chest wall surgery, ensuring accurate documentation and reimbursement for healthcare providers.
CPT code 19272 is used to describe an extensive chest wall surgery. This code is specifically assigned to procedures that involve a significant surgical intervention on the chest wall, which may include the removal of tumors, reconstruction, or other complex surgical tasks aimed at treating serious conditions affecting the chest area. This type of surgery typically requires a high level of expertise and is often performed to address severe or life-threatening issues.
For CPT code 19272, which pertains to extensive chest wall surgery, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required. This could apply if the surgery is more complex or time-consuming than usual.
2. Modifier 50 - Bilateral Procedure: Used if the surgery is performed on both sides of the chest wall.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session. This is relevant if other surgeries are performed in conjunction with the chest wall surgery.
4. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day. This could apply if the chest wall surgery is performed separately from other procedures.
5. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
6. Modifier 66 - Surgical Team: Used when a highly complex procedure requires the services of several physicians, often of different specialties, working together as a team.
7. Modifier 76 - Repeat Procedure by Same Physician: Used if the same physician needs to repeat the chest wall surgery within a short period.
8. Modifier 77 - Repeat Procedure by Another Physician: Used if a different physician needs to repeat the chest wall surgery within a short period.
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: Used if the patient needs to return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used if an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery.
11. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon is required for a minimal portion of the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required, and a qualified resident surgeon is not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in the surgery.
These modifiers help provide additional information about the circumstances under which the extensive chest wall surgery was performed, ensuring accurate billing and reimbursement.
The CPT code 19272 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 19272. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement.
Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 19272.
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