CPT code 19283 is used for the placement of a breast localization device, such as a clip, during a first structure procedure.
CPT code 19283 is used for the placement of a percutaneous device for breast localization, specifically for the first lesion. This procedure involves inserting a device through the skin to mark the location of a breast lesion, which helps guide surgeons during a biopsy or surgery.
For CPT code 19283, which pertains to a specific procedure, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, typically by the radiologist or physician interpreting the results.
2. Modifier TC - Technical Component: Applied when only the technical component of the service is being billed, usually by the facility providing the equipment and technical staff.
3. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both breasts during the same session.
4. Modifier 52 - Reduced Services: Applied when the service provided is less extensive than described in the CPT code.
5. Modifier 53 - Discontinued Procedure: Used when the 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: 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 by Same Physician: Applied when the same procedure is repeated by the same physician on the same day.
8. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician on the same day.
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 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: Applied when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
11. Modifier 99 - Multiple Modifiers: 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.
CPT code 19283 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for various services, including CPT code 19283. Additionally, the reimbursement may vary depending on the local policies of the Medicare Administrative Contractor (MAC) that oversees the region where the service is provided. It is essential to consult the MPFS and the relevant MAC guidelines to determine the exact reimbursement rate and any additional requirements for CPT code 19283.
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