CPT code 32940 is used for procedures involving the revision of the lung, helping healthcare providers categorize and report medical services.
CPT code 32940 is used to describe the surgical procedure for the revision of the lung. This code is specifically applied when a surgeon needs to perform corrective surgery on a previously operated lung. The revision may be necessary due to complications, such as scar tissue formation, or to improve the function of the lung after an initial surgery. This code ensures that healthcare providers can accurately document and bill for the complexity and expertise required in performing such a delicate and critical procedure.
For the CPT code 32940, which pertains to the revision of the lung, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
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 51 - Multiple Procedures: This is used when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.
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: Used when a procedure is 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 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure, each surgeon should report their distinct operative work by adding this modifier.
7. Modifier 66 - Surgical Team: This is used when a complex procedure requires the services of several physicians, often of different specialties, working together as a team.
8. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: Used when the same procedure is repeated by the same provider.
9. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This is used when a procedure is repeated by a different provider.
10. 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.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This is used when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
12. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: This is used when an assistant surgeon is required on a limited basis.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required, and a qualified resident surgeon is not available.
15. Modifier 99 - Multiple Modifiers: This is used when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association (AMA) and payer-specific policies. Proper documentation is crucial to support the use of any modifier.
The CPT code 32940, which involves a revision procedure, is subject to reimbursement considerations under Medicare. To determine if this specific CPT code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare, including whether a particular CPT code is reimbursable.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide region-specific guidance on coverage and reimbursement for CPT codes. They may have local coverage determinations (LCDs) that affect whether a service is reimbursed in a particular area.
Therefore, to ascertain if CPT code 32940 is reimbursed by Medicare, providers should consult the MPFS for national guidance and check with their respective MAC for any local policies that might influence reimbursement.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 32940, RevFind provides unparalleled accuracy in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and maximize your financial outcomes.
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
