CPT code 34701 is used for reporting endovascular repair of an aortic aneurysm using a modular bifurcated prosthesis, ensuring accurate procedure documentation.
CPT code 34701 is used to describe an endovascular repair procedure of the infrarenal abdominal aorta or iliac artery using a modular bifurcated prosthesis. This code specifically pertains to the placement of an endograft, which is a type of stent graft used to reinforce the weakened section of the artery and prevent an aneurysm from rupturing. The procedure is minimally invasive, typically involving small incisions and the use of imaging guidance to accurately position the endograft within the artery. This code is crucial for healthcare providers to accurately document and bill for the specific resources and expertise required for this complex vascular procedure.
For CPT code 34701, which involves endovascular repair procedures, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and their reasons for use:
1. Modifier 22 (Increased Procedural Services): Used when the work required to perform the procedure is substantially greater than typically required. This could be due to increased complexity or additional time spent.
2. Modifier 50 (Bilateral Procedure): Applied if the procedure is performed on both sides of the body during the same session.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This helps indicate that more than one procedure was carried out.
4. Modifier 52 (Reduced Services): Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 (Distinct Procedural Service): Indicates that a procedure or service was distinct or independent from other services performed on the same day. This is often used to clarify that procedures are not components of a more comprehensive service.
6. Modifier 62 (Two Surgeons): Applied when two surgeons work together as primary surgeons performing distinct parts of a procedure.
7. Modifier 66 (Surgical Team): Used when a team of surgeons is required to perform the procedure due to its complexity.
8. Modifier 76 (Repeat Procedure by Same Physician): Indicates that a procedure or service was repeated by the same physician subsequent to the original procedure.
9. Modifier 77 (Repeat Procedure by Another Physician): Used when a procedure is repeated by a different physician.
10. Modifier 78 (Unplanned Return to the Operating/Procedure Room): Used when a related procedure is performed during the postoperative period due to complications.
11. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Indicates that a procedure performed during the postoperative period was unrelated to the original procedure.
12. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required for the procedure.
13. Modifier 81 (Minimum Assistant Surgeon): Indicates that a minimum assistant surgeon was required.
14. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is necessary, and a qualified resident is not available.
15. Modifier 99 (Multiple Modifiers): Used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 34701, like all CPT codes, is subject to reimbursement considerations under Medicare. To determine if CPT code 34701 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in interpreting and implementing Medicare policies at the regional level. They may have specific guidelines or coverage determinations that affect whether CPT code 34701 is reimbursed in a particular area. Therefore, healthcare providers should verify the reimbursement status of CPT code 34701 by reviewing the MPFS and consulting with their local MAC to ensure compliance and accurate billing practices.
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 34701, RevFind provides unparalleled accuracy in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and secure your financial health.
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
