CPT code 32655 is used for a thoracoscopy procedure to remove bullae, which are air-filled sacs in the lungs.
CPT code 32655 is a medical billing code used to describe the procedure of thoracoscopy for the resection of bullae. This procedure involves using a thoracoscope, a specialized instrument with a camera, to visually examine the chest cavity and surgically remove bullae, which are air-filled sacs that can form on the surface of the lungs. The resection of bullae is typically performed to improve lung function and alleviate symptoms in patients with conditions such as emphysema or other forms of chronic obstructive pulmonary disease (COPD). This minimally invasive approach allows for a more precise removal of the bullae with reduced recovery time compared to traditional open surgery.
For CPT code 32655, which involves thoracoscopy for the resection of bullae, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the procedure required significantly more work than typically required. This could be due to increased complexity or time.
2. Modifier 51 (Multiple Procedures): Apply this modifier if multiple procedures were performed during the same surgical session. It indicates that the procedure was one of several performed.
3. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day. It is often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 62 (Two Surgeons): If two surgeons were required to perform the procedure due to its complexity, this modifier should be used to indicate that both surgeons were actively involved.
5. Modifier 66 (Surgical Team): Use this modifier when the procedure requires a surgical team due to its complexity, indicating that multiple professionals were involved.
6. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used if the same procedure was repeated by the same physician on the same day.
7. Modifier 77 (Repeat Procedure by Another Physician): Apply this modifier if the procedure was repeated by a different physician on the same day.
8. Modifier 78 (Unplanned Return to the Operating Room): Use this modifier if the patient had to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
10. Modifier 80 (Assistant Surgeon): If an assistant surgeon was necessary for the procedure, this modifier should be used to indicate their involvement.
11. Modifier 81 (Minimum Assistant Surgeon): Use this modifier if an assistant surgeon was required for a minimal portion of the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is necessary, and a qualified resident surgeon is not available.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify payer-specific guidelines, as modifier usage can vary.
CPT code 32655 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered.
Whether CPT code 32655 is reimbursed by Medicare depends on several factors, including the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in your geographic region. Each MAC may have unique coverage determinations and guidelines that influence the reimbursement of specific CPT codes.
Therefore, it is essential to consult the local MAC's policies and the MPFS to determine the reimbursement status of CPT code 32655 for your practice.
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 specific codes like 32655. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and ensure you're receiving the full reimbursement you deserve.
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