CPT code 33967 is used for the procedure of inserting an intra-aortic percutaneous device, aiding in detailed medical procedure documentation.
CPT code 33967 is used to describe the procedure of inserting an intra-aortic percutaneous device. This code is typically utilized when a healthcare provider performs a minimally invasive procedure to place a device within the aorta, which is the main artery that carries blood from the heart to the rest of the body. The insertion of such a device is often necessary for patients who require mechanical circulatory support, such as those with severe heart failure or other cardiac conditions. The procedure is performed percutaneously, meaning it is done through the skin using a needle or catheter, which reduces the need for open surgery and can lead to quicker recovery times for patients.
For the CPT code 33967, "Insert i-aort percut device," the following modifiers may be applicable depending on the specific circumstances of the procedure and the billing requirements:
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 52 - Reduced Services: This modifier is applicable if the procedure was partially reduced or eliminated at the physician's discretion. It indicates that the service provided was less than usually required.
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 often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider subsequent to the original procedure.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider.
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: This modifier is used when a related procedure is performed during the postoperative period of the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
8. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
11. Modifier 99 - Multiple Modifiers: This modifier 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 payer's guidelines and the specific circumstances of the procedure. Proper documentation is essential to support the use of any modifier.
The CPT code 33967 is subject to reimbursement by Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) in your region.
The MPFS provides a comprehensive list of services and procedures that Medicare covers, along with the associated reimbursement rates. However, the final determination of coverage and reimbursement for CPT code 33967 is influenced by the local policies and guidelines established by the MAC, which administers Medicare claims for specific geographic areas.
Therefore, healthcare providers should consult the MPFS and their regional MAC to confirm the reimbursement status and any specific requirements or documentation needed for CPT code 33967.
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