CPT code 31660 is used for bronchial thermoplasty of one lobe, a procedure to treat severe asthma by reducing airway smooth muscle.
CPT code 31660 is used to describe a medical procedure known as bronchial thermoplasty, which is performed on one lobe of the lung. This procedure is typically used to treat severe asthma by applying controlled thermal energy to the airway walls. The goal is to reduce the amount of smooth muscle in the airways, thereby decreasing their ability to constrict and improving airflow. This code is specifically used to bill for the bronchial thermoplasty procedure when it is conducted on a single lobe of the lung.
For CPT code 31660, which pertains to bronchial thermoplasty of one lobe, the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both lungs during the same session. However, bronchial thermoplasty is typically performed on one lobe at a time, so this modifier is rarely applicable.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day. It may be necessary if the bronchial thermoplasty is performed in conjunction with other procedures that are not typically reported together.
4. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated on the same day by the same physician, this modifier is used to indicate the repetition.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated on the same day by a different physician.
6. 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 if the patient needs to return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If a procedure is performed during the postoperative period of another procedure but is unrelated, this modifier is used.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 31660 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the policies of the local Medicare Administrative Contractor (MAC). The MPFS provides a list of services and their corresponding reimbursement rates, which are updated annually. If CPT code 31660 is listed in the MPFS, it indicates that Medicare has established a reimbursement rate for this service. However, the final determination of reimbursement also depends on the specific guidelines and coverage policies set by the MAC in your region. MACs have the authority to make local coverage determinations (LCDs) that can affect whether a particular service is reimbursed. Therefore, it is essential to consult the MPFS and the relevant MAC's policies to confirm the reimbursement status of CPT code 31660.
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