CPT code 33871 is used for the procedure involving transverse aortic arch grafting with hypothermia, a complex cardiovascular surgery.
CPT code 33871 is used to describe a surgical procedure involving the transverse aortic arch graft with hypothermic circulatory arrest. This complex cardiovascular surgery is typically performed to repair or replace a section of the aortic arch, which is the part of the main artery that bends between the ascending and descending aorta. The procedure often involves stopping the patient's circulation and cooling the body to protect the brain and other vital organs while the surgery is performed. This code is crucial for accurately documenting and billing for this specialized and high-risk surgical intervention.
For CPT code 33871, which involves a complex surgical procedure, the use of modifiers may be necessary to provide additional information about the service provided. Here is a list of potential modifiers that could be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required. This could be due to factors such as increased intensity, time, technical difficulty, or severity of the patient's condition.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was performed.
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 particularly useful when procedures are not typically reported together but are appropriate under the circumstances.
4. Modifier 62 - Two Surgeons: If two surgeons are required to perform the 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 used when a team of surgeons is required to perform the procedure due to its complexity.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: If the procedure needs to be repeated by the same provider, this modifier is applicable.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: If the procedure is repeated by a different provider, this modifier is used.
8. 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 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 during the postoperative period, this modifier is applicable.
These modifiers help provide clarity and ensure accurate billing and reimbursement for the services rendered. It is essential to use them appropriately to reflect the specific circumstances of the procedure accurately.
CPT code 33871 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that outlines the payment rates for services covered by Medicare. To determine if CPT code 33871 is reimbursed, healthcare providers should consult the MPFS to see if the code is listed and what the associated payment rate is.
Additionally, Medicare Administrative Contractors (MACs) play a significant role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to make coverage decisions based on local coverage determinations (LCDs). Therefore, it is essential for providers to check with their specific MAC to understand any regional policies or guidelines that might affect the reimbursement of CPT code 33871.
In summary, while CPT code 33871 may be reimbursed by Medicare, providers need to verify its inclusion in the MPFS and consult their MAC for any specific coverage criteria or limitations.
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 33871, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can 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
