CPT code 33783 is for the Nikaidoh procedure with ostia implantation, a complex heart surgery involving arterial repositioning.
CPT code 33783 is used to describe the Nikaidoh procedure with ostia implantation. This is a complex cardiac surgical procedure primarily performed to correct certain congenital heart defects, such as transposition of the great arteries with ventricular septal defect and pulmonary stenosis. The Nikaidoh procedure involves repositioning the aorta and pulmonary artery, as well as implanting the coronary ostia (the openings of the coronary arteries) into the new aortic position. This code is utilized by healthcare providers to accurately document and bill for this specific surgical intervention.
For CPT code 33783, which pertains to the Nikaidoh procedure with ostia implantation, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or unexpected findings during the surgery.
2. Modifier 51 - Multiple Procedures: If the Nikaidoh procedure is performed in conjunction with other procedures during the same surgical session, this modifier indicates that multiple procedures were 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 particularly relevant if the Nikaidoh procedure is performed in a separate anatomical site or through a separate incision.
4. Modifier 62 - Two Surgeons: If two surgeons are required to perform the Nikaidoh procedure due to its complexity, this modifier indicates that each surgeon performed a distinct part of the procedure.
5. Modifier 66 - Surgical Team: This modifier is applicable when the procedure requires a surgical team due to its complexity, indicating that multiple professionals were involved in the surgery.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: If the patient needs to return to the operating room for a related procedure during the postoperative period, this modifier is used.
7. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required to help perform the Nikaidoh procedure.
8. Modifier 81 - Minimum Assistant Surgeon: If an assistant surgeon is required on a limited basis, this modifier is applicable.
9. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary, and a qualified resident 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 with the latest coding guidelines and payer-specific policies to ensure appropriate use of modifiers.
The CPT code 33783, associated with the Nikaidoh procedure with ostia implantation, is subject to reimbursement considerations under Medicare. To determine if this specific CPT code is reimbursed by Medicare, healthcare providers should consult the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates.
Additionally, it is essential to verify with the local Medicare Administrative Contractor (MAC), as they are responsible for processing claims and can provide region-specific guidance on coverage and reimbursement policies. The MAC may have additional criteria or documentation requirements that must be met for the CPT code 33783 to be reimbursed.
Therefore, it is crucial for healthcare providers to stay informed about updates to the MPFS and any directives from their MAC to ensure proper billing and reimbursement for this procedure.
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 33783, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and enhance 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
