CPT code 32220 is a procedure code used by healthcare providers to describe the surgical release of a lung, aiding in accurate service documentation.
CPT code 32220 is a medical billing code used to describe the surgical procedure for the release of a lung. This procedure typically involves the removal of fibrous tissue or adhesions that are restricting the lung's movement, thereby improving lung function. It is often performed to treat conditions such as pleural effusion or after an infection that has caused the lung to become encased in scar tissue. By using this code, healthcare providers can accurately document and bill for the specific surgical intervention performed to restore normal lung function.
For CPT code 32220, which pertains to the release of lung, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: This modifier is used when 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 procedure is performed on both lungs during the same session, this modifier indicates that the procedure was performed bilaterally.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.
4. 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. It is used to identify procedures that are not normally reported together but are appropriate under the circumstances.
5. 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.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider on the same day.
7. 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 patient requires a return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure performed during the postoperative period is unrelated to the original procedure.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association and payer-specific policies. Proper documentation is crucial to support the use of any modifier.
CPT code 32220, which involves a specific medical procedure, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding reimbursement rates.
Additionally, it's important to consult with the local Medicare Administrative Contractor (MAC), as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 32220. MACs may have localized policies or interpretations that affect whether and how a particular service is reimbursed. Therefore, checking both the MPFS and consulting with the MAC will provide the most accurate and up-to-date information regarding the reimbursement status of CPT code 32220 under Medicare.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level, including CPT code 32220, and by individual payer. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
