CPT code 32484 is a medical code used to describe a surgical procedure where a segment of the lung is removed, aiding in standardized documentation.
CPT code 32484 is used to describe a surgical procedure known as a segmentectomy. This procedure involves the removal of a segment of the lung, which is a portion of a lobe. Segmentectomy is typically performed to excise a localized area of diseased lung tissue, often due to conditions such as lung cancer or localized infections. The goal of this surgery is to remove the affected segment while preserving as much healthy lung tissue as possible, thereby maintaining optimal lung function. This code is crucial for accurate billing and documentation in the healthcare revenue cycle, ensuring that providers are reimbursed appropriately for the services rendered.
For CPT code 32484, which pertains to a segmentectomy, 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 segmentectomy required significantly more work than typically required. This could be due to unusual anatomy or complications during the procedure.
2. Modifier 50 (Bilateral Procedure): If the segmentectomy is performed bilaterally, this modifier should be applied to indicate that the procedure was done on both sides.
3. Modifier 51 (Multiple Procedures): When the segmentectomy is performed in conjunction with other procedures during the same surgical session, this modifier indicates multiple procedures.
4. Modifier 52 (Reduced Services): If the segmentectomy was partially reduced or not completed as planned, this modifier should be used to reflect the reduced service.
5. Modifier 53 (Discontinued Procedure): Apply this modifier if the segmentectomy was started but discontinued due to extenuating circumstances or patient safety concerns.
6. Modifier 59 (Distinct Procedural Service): Use this modifier when the segmentectomy is performed as a distinct service from other procedures on the same day, indicating that it is not part of a bundled service.
7. Modifier 62 (Two Surgeons): If two surgeons are required to perform the segmentectomy, this modifier indicates that each surgeon is performing a distinct part of the procedure.
8. Modifier 66 (Surgical Team): When a segmentectomy requires a surgical team due to its complexity, this modifier should be used.
9. Modifier 76 (Repeat Procedure by Same Physician): If the segmentectomy needs to be repeated by the same physician, this modifier indicates the repeat nature of the procedure.
10. Modifier 77 (Repeat Procedure by Another Physician): Use this modifier if the segmentectomy is repeated by a different physician.
11. Modifier 78 (Unplanned Return to the Operating/Procedure Room): If the patient needs to return to the operating room for a related procedure during the postoperative period, this modifier is applicable.
12. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Apply this modifier if the segmentectomy is performed during the postoperative period of another procedure but is unrelated to the initial surgery.
These modifiers help provide additional information about the circumstances under which the segmentectomy was performed, ensuring accurate billing and reimbursement. Always consult the latest coding guidelines and payer-specific policies when applying modifiers.
CPT code 32484, which is associated with segmentectomy, is subject to reimbursement by Medicare, but this is contingent upon several factors. The Medicare Physician Fee Schedule (MPFS) plays a crucial role in determining whether a specific CPT code is reimbursed. The MPFS outlines the payment rates for services provided by physicians and other healthcare professionals, and it is updated annually to reflect changes in practice costs and policy adjustments.
For CPT code 32484, reimbursement is possible if the procedure is deemed medically necessary and is performed in accordance with Medicare guidelines. However, the final determination of reimbursement is also influenced by the local Medicare Administrative Contractor (MAC). MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that may affect the reimbursement of specific procedures.
Therefore, while CPT code 32484 is generally reimbursable under Medicare, healthcare providers should verify the specific coverage policies and reimbursement rates with their respective MAC to ensure compliance and proper billing.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments down to the CPT code level, including specific codes like 32484. Schedule a demo today to see how RevFind can help you maximize reimbursements from each payer.
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
