CPT code 33991 is used for the insertion of a percutaneous ventricular assist device in both the left heart artery and vein.
CPT code 33991 is used to describe the percutaneous insertion of a ventricular assist device (VAD) into both the left heart's arterial and venous systems. This procedure involves the placement of a mechanical pump that helps support heart function and blood flow in individuals with weakened hearts. The code specifically pertains to the insertion technique that is performed through the skin, rather than through open surgery, making it a less invasive option for patients requiring circulatory support.
For CPT code 33991, which involves the insertion of a percutaneous ventricular assist device (VAD) into both the left heart artery and vein, the following modifiers may be applicable:
1. 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 may be necessary if multiple procedures are performed and need to be distinguished from one another.
2. Modifier 51 (Multiple Procedures): If multiple procedures are performed during the same session, this modifier is used to indicate that more than one procedure was performed. It helps in the correct billing of multiple services.
3. Modifier 26 (Professional Component): This modifier is used when only the professional component of the service is being billed. It is applicable if the service involves both a professional and technical component, and only the professional component is provided by the billing entity.
4. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to provide a service is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
5. Modifier 76 (Repeat Procedure by Same Physician): If the same procedure is repeated by the same physician, this modifier is used to indicate that the procedure was repeated on the same day.
6. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when a procedure is repeated by a different physician on the same day.
7. 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 returns to the operating room for a related procedure during the postoperative period of the initial procedure.
8. 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 of another procedure.
These modifiers help in accurately representing the circumstances under which the procedure was performed, ensuring proper billing and reimbursement. Always ensure that documentation supports the use of any modifier applied.
CPT code 33991 is subject to reimbursement considerations under 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) for the region in which the service is provided.
The MPFS outlines the payment rates for services covered by Medicare, and each MAC may have additional local coverage determinations that influence reimbursement.
Therefore, to determine if CPT code 33991 is reimbursed by Medicare, healthcare providers should consult the MPFS for the current year and check with their regional MAC for any specific coverage policies or requirements.
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 CPT code 33991, 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
