CPT code 34706 is used for reporting endovascular repair of an aorto-biiliac artery using a modular bifurcated prosthesis.
CPT code 34706 is used to describe the endovascular repair of an aorto-bi-iliac artery using a modular bifurcated prosthesis. This procedure involves the insertion of a specialized graft to repair or reinforce the aorta and the iliac arteries, which are major blood vessels in the abdomen and pelvis. The code is specifically used when the repair is performed using a modular system, which allows for customization and precise fitting of the graft to the patient's anatomy. This procedure is typically indicated for patients with aneurysms or other vascular conditions affecting these arteries, aiming to prevent rupture and ensure proper blood flow.
For CPT code 34706, which pertains to endovascular repair procedures, the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: This modifier is used when the procedure is performed on both sides of the body. Since CPT code 34706 involves a bilateral iliac repair, this modifier may be necessary if the procedure is performed on both iliac arteries.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that the procedure is one of several performed.
3. Modifier 52 - Reduced Services: This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion.
4. 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.
5. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, this modifier indicates that both surgeons are working together as primary surgeons.
6. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires a surgical team.
7. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure, this modifier is used to indicate that the procedure was repeated.
8. Modifier 77 - Repeat Procedure by Another Physician: This modifier 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 if the patient needs to return 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 modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
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 34706, which pertains to a specific medical procedure, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services and procedures that are covered by Medicare, along with their respective reimbursement rates.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to make coverage determinations based on local policies and guidelines. Therefore, whether CPT code 34706 is reimbursed can vary depending on the specific MAC jurisdiction and any local coverage determinations (LCDs) that may apply.
Healthcare providers should verify the reimbursement status of CPT code 34706 by reviewing the MPFS and consulting with their respective MAC to ensure compliance with Medicare's billing and coverage requirements.
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