CPT code 31646 is a procedure code used by healthcare providers to describe a bronchoscopy with therapeutic aspiration performed subsequently.
CPT code 31646 is used to describe a bronchoscopy procedure with therapeutic aspiration of a subsequent substance. This code is applied when a healthcare provider performs a bronchoscopy, which is an endoscopic technique used to view the inside of the airways and lungs. During this procedure, the provider not only examines the bronchial passages but also performs a therapeutic aspiration, meaning they remove a substance such as mucus, fluid, or a foreign object from the airways. This code is specific to cases where the aspiration is conducted as a follow-up or subsequent action during the bronchoscopy.
For the CPT code 31646, which involves bronchoscopy with therapeutic aspiration, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to unusual procedural complexity or patient condition.
2. Modifier 26 - Professional Component: If the procedure involves both a professional and technical component, and only the professional component is being billed, this modifier should be used.
3. Modifier 52 - Reduced Services: This modifier is applicable when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be applied.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure is repeated by a different physician.
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 is used when a related procedure is performed during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is applicable when an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier should be used.
11. Modifier 81 - Minimum Assistant Surgeon: This is used 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 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier is used to indicate that multiple modifiers apply.
These modifiers help provide additional information about the circumstances of the procedure and ensure accurate billing and reimbursement. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
The CPT code 31646 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and healthcare providers for services rendered. Each MAC, which administers Medicare claims in different jurisdictions, may have specific local coverage determinations (LCDs) that affect whether and how a particular CPT code like 31646 is reimbursed.
Therefore, it is crucial for healthcare providers to consult the MPFS and their respective MAC's policies to understand the reimbursement specifics for CPT code 31646.
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