CPT code 30620 is used for intranasal reconstruction, a procedure involving the surgical repair or reshaping of the nasal structure.
CPT code 30620 is used to describe the surgical procedure of intranasal reconstruction. This code is specifically assigned to surgeries that involve the reconstruction of the nasal passageways, which may be necessary due to trauma, congenital defects, or other medical conditions affecting the nasal structure. The procedure aims to restore normal function and improve airflow through the nasal passages, often enhancing the patient's breathing and overall nasal health. This code is utilized by healthcare providers to accurately document and bill for the surgical services provided during the intranasal reconstruction.
For CPT code 30620, Intranasal reconstruction, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to perform the procedure is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 50 - Bilateral Procedure: If the intranasal reconstruction is performed on both sides of the nose during the same operative session, this modifier should be used to indicate a bilateral procedure.
3. Modifier 51 - Multiple Procedures: Apply this modifier when multiple procedures are performed during the same surgical session. It indicates that multiple services were provided.
4. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion. Documentation should support the reason for the reduction.
5. 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. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Use this modifier when the procedure is repeated by a different provider 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: This modifier is 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: Apply this modifier when an unrelated procedure is performed by the same provider during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when a non-physician provider assists in the surgery.
These modifiers should be applied based on the specific details of the procedure and the circumstances under which it was performed. Proper documentation is crucial to support the use of any modifier.
CPT code 30620, which pertains to intranasal reconstruction, is subject to reimbursement by Medicare, but this depends on several factors. The Medicare Physician Fee Schedule (MPFS) is a crucial resource for determining whether a specific CPT code is reimbursed by Medicare. The MPFS outlines the payment rates for services covered under Medicare Part B, including surgical procedures like those associated with CPT code 30620.
However, it's important to note that reimbursement can also be influenced by the local policies of the Medicare Administrative Contractor (MAC) that services your region. MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that may affect whether a particular service is reimbursed. Therefore, while CPT code 30620 may be listed on the MPFS, healthcare providers should verify with their specific MAC to ensure compliance with any local coverage requirements or restrictions that might impact reimbursement.
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