CPT code 33518 is used for a procedure involving coronary artery bypass grafting using both artery and vein for two grafts.
CPT code 33518 is used to describe a coronary artery bypass graft (CABG) procedure where two grafts are performed using a combination of artery and vein. This surgical procedure is typically employed to improve blood flow to the heart by bypassing blocked or narrowed coronary arteries. The use of both artery and vein grafts can enhance the durability and effectiveness of the bypass, as arterial grafts are often more resistant to atherosclerosis compared to vein grafts. This code is crucial for accurate billing and documentation in the healthcare revenue cycle, ensuring that providers are reimbursed appropriately for the complexity and resources involved in performing this specific type of CABG surgery.
For CPT code 33518, which pertains to coronary artery bypass grafting (CABG) involving both artery and vein grafts, 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 unusual circumstances or complications during surgery.
2. Modifier 51 (Multiple Procedures): Apply this modifier when multiple procedures are performed during the same surgical session. This is common in CABG surgeries where additional procedures might be necessary.
3. 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 prevent bundling of services that are typically not reported together.
4. Modifier 62 (Two Surgeons): If two surgeons are required to perform distinct parts of the CABG procedure, this modifier indicates that both surgeons are involved and should be reimbursed accordingly.
5. Modifier 66 (Surgical Team): Use this modifier when a highly complex procedure requires the skills of a surgical team, indicating that multiple professionals are involved in the surgery.
6. Modifier 78 (Unplanned Return to the Operating/Procedure Room): This modifier is applicable 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): Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement. Always ensure that the use of modifiers is supported by appropriate documentation in the patient's medical record.
CPT code 33518 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the policies of the local Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive listing of fees used to reimburse physicians and other healthcare providers for services covered by Medicare. However, the final decision on reimbursement for CPT code 33518 may vary based on the specific guidelines and coverage determinations set forth by the MAC in your region.
It is essential for healthcare providers to verify the specific reimbursement details with their local MAC to ensure compliance and accurate billing practices.
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 33518, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and optimize your revenue cycle management.
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
