CPT code 34471 is used for the procedure involving the removal of a clot from a vein, aiding in accurate procedure documentation and reimbursement.
CPT code 34471 is used to describe the surgical procedure for the removal of a clot from a vein. This procedure is typically performed to restore normal blood flow in cases where a clot has formed and is obstructing circulation within a vein. The removal of the clot can help alleviate symptoms such as swelling, pain, and potential complications associated with venous thrombosis. This code is utilized by healthcare providers to accurately document and bill for the procedure within the medical billing and coding system.
For CPT code 34471, "Removal of vein clot," the following modifiers may be applicable depending on the specific circumstances of the procedure:
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 50 (Bilateral Procedure): If the procedure is performed on both sides of the body, this modifier should be used to indicate that it was a bilateral procedure.
3. Modifier 51 (Multiple Procedures): Apply this modifier when multiple procedures are performed during the same surgical session. It indicates that more than one procedure was carried out.
4. Modifier 52 (Reduced Services): Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
5. 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.
6. Modifier 76 (Repeat Procedure by Same Physician): If the same procedure is repeated by the same physician, this modifier should be used.
7. Modifier 77 (Repeat Procedure by Another Physician): Use this modifier if the procedure is repeated by a different physician.
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 when the patient returns 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): Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 (Assistant Surgeon): Use this modifier if an assistant surgeon was required during the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when a minimum assistant surgeon is required.
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.
13. Modifier 99 (Multiple Modifiers): If more than one modifier is applicable, this modifier indicates that multiple modifiers are being used.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always consult the latest coding guidelines and payer-specific requirements when applying modifiers.
The CPT code 34471 is subject to reimbursement considerations under Medicare. To determine if this specific code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered by Medicare.
Additionally, it is important to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they are responsible for processing claims and can provide guidance on coverage specifics, including any local coverage determinations (LCDs) that may affect reimbursement for CPT code 34471.
Each MAC may have different interpretations or additional requirements, so verifying with them is crucial for accurate billing and reimbursement.
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