CPT code 20982 is used for the procedure to ablate bone tumors through a percutaneous approach.
CPT code 20982 is used for the procedure where a healthcare provider destroys one or more bone tumors using a minimally invasive technique, typically involving needles or probes inserted through the skin.
For CPT code 20982, which is used for the percutaneous ablation of bone tumors, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 (Increased Procedural Services): Used when the work required to perform the procedure is substantially greater than typically required. This could be due to increased complexity or difficulty of the procedure.
2. Modifier 50 (Bilateral Procedure): Applied if the procedure is performed on both sides of the body during the same session.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
4. Modifier 52 (Reduced Services): Applied when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 (Distinct Procedural Service): Used to indicate that the procedure is distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
6. Modifier 76 (Repeat Procedure by Same Physician): Used when the same procedure is repeated by the same physician on the same day.
7. Modifier 77 (Repeat Procedure by Another Physician): Applied when the same procedure is repeated by a different physician on the same day.
8. 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.
9. 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.
10. Modifier LT (Left Side): Used to specify that the procedure was performed on the left side of the body.
11. Modifier RT (Right Side): Used to specify that the procedure was performed on the right side of the body.
12. Modifier XS (Separate Structure): Indicates that a service is distinct because it was performed on a separate organ/structure.
13. Modifier XE (Separate Encounter): Used to indicate that a service is distinct because it was performed during a separate encounter.
14. Modifier XP (Separate Practitioner): Indicates that a service is distinct because it was performed by a different practitioner.
15. Modifier XU (Unusual Non-Overlapping Service): Used to indicate that a service is distinct because it does not overlap usual components of the main service.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
When considering whether Medicare reimburses for CPT code 20982, which pertains to the percutaneous ablation of bone tumors, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and Local Coverage Determinations (LCDs) for the most accurate and up-to-date information.
As of the latest available data, CPT code 20982 is generally reimbursed by Medicare, provided that the procedure is deemed medically necessary and meets the specific criteria outlined by Medicare guidelines. The reimbursement amount can vary based on geographic location, the setting in which the procedure is performed (e.g., hospital outpatient department, ambulatory surgical center), and other factors.
For a precise reimbursement amount, healthcare providers should refer to the MPFS or use the Medicare Administrative Contractor (MAC) lookup tools. As an example, the national average reimbursement for CPT code 20982 might be approximately $1,200, but this figure can fluctuate.
To ensure compliance and accurate billing, it is advisable to verify the specific coverage details and reimbursement rates through the appropriate Medicare resources or consult with a healthcare revenue cycle management expert.
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