CPT code 33863 is used for the surgical procedure involving the placement of a graft in the ascending aorta to repair or replace a section.
CPT code 33863 is used to describe the surgical procedure involving the replacement of the ascending aorta with a graft. This procedure is typically performed to treat conditions such as aneurysms or dissections of the ascending aorta, which is the section of the aorta that rises from the heart. The graft serves to reinforce or replace the weakened or damaged section of the aorta, ensuring proper blood flow and reducing the risk of rupture. This code is specific to the ascending aorta and does not include procedures involving other sections of the aorta.
When dealing with CPT code 33863 for an ascending aortic graft, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and their purposes:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to factors such as increased complexity or time.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier 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.
4. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier indicates that both surgeons were necessary and 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: If the procedure needs to be repeated by the same physician, this modifier is used to indicate the repetition.
7. Modifier 77 - Repeat Procedure by Another Physician: If the procedure is repeated by a different physician, this modifier is used to indicate the repetition by another provider.
8. Modifier 78 - Unplanned Return to the Operating Room: This modifier is used if the patient needs 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: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier is used.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier indicates their involvement.
11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
Each modifier serves a specific purpose and should be applied based on the unique circumstances surrounding the procedure to ensure accurate billing and reimbursement.
CPT code 33863, which involves an ascending aortic graft, 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 a comprehensive list of services covered by Medicare, along with their respective reimbursement rates.
Additionally, it is important to consult with the relevant Medicare Administrative Contractor (MAC) for your region. MACs are responsible for processing Medicare claims and can provide specific guidance on whether CPT code 33863 is covered and reimbursed in your area. They may also offer insights into any local coverage determinations or additional documentation requirements that could affect reimbursement. Therefore, checking both the MPFS and consulting with your MAC will provide the most accurate and up-to-date information regarding the reimbursement status of CPT code 33863.
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 33863, 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
