CPT code 34704 is used for reporting endovascular repair of an iliac artery with a non-covered stent graft, indicating a specific medical procedure.
CPT code 34704 is used to describe the endovascular repair of an abdominal aorta or iliac artery using an unlisted endograft. This procedure involves the placement of a stent graft within the artery to reinforce the vessel wall and prevent aneurysm rupture. The code specifically indicates that the repair is performed without the use of a pre-defined graft type, allowing for flexibility in the choice of endograft based on the patient's specific anatomical needs. This code is typically used by vascular surgeons and interventional radiologists who perform complex endovascular procedures.
For CPT code 34704, which involves endovascular repair, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both sides of the body during the same session.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.
3. Modifier 52 - Reduced Services: This is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 59 - Distinct Procedural Service: This modifier is applied to indicate that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier is used.
6. Modifier 66 - Surgical Team: This modifier is applicable when a team of surgeons is necessary to perform the procedure.
7. Modifier 76 - Repeat Procedure by Same Physician: If the same physician repeats the procedure, this modifier is used to indicate the repetition.
8. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure is repeated by a different physician.
9. 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.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This indicates that the procedure is unrelated to the original surgery and is performed during the postoperative period.
11. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: This is used when a minimum assistant surgeon is necessary.
13. 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.
14. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier is used to indicate that multiple modifiers apply.
Each of these modifiers serves a specific purpose and should be used in accordance with the specific details of the procedure and the payer's guidelines. Proper use of modifiers is crucial for accurate billing and reimbursement.
The CPT code 34704 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. Whether CPT code 34704 is reimbursed by Medicare depends on several factors, including its inclusion in the MPFS and the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in your region.
Each MAC has the authority to interpret national Medicare policies and may have local coverage determinations (LCDs) that affect reimbursement. Therefore, it is crucial for healthcare providers to verify with their respective MAC whether CPT code 34704 is covered and reimbursed under Medicare. Additionally, providers should ensure that all necessary documentation and coding guidelines are adhered to in order to facilitate successful reimbursement.
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