CPT code 34711 is used for the delayed placement of an extension prosthesis for each additional segment in medical procedures.
CPT code 34711 is used to describe the delayed placement of an extension prosthesis for each additional vessel. This code is typically utilized in the context of endovascular procedures, where an extension prosthesis is needed to ensure proper vascular repair or support. The term "delayed placement" indicates that the extension prosthesis is not placed during the initial procedure but at a later time, often due to clinical considerations or the need for further intervention. This code is an add-on, meaning it is used in conjunction with a primary procedure code to account for the additional work and resources required for placing each extra extension prosthesis.
For CPT code 34711, which involves the delayed placement of an extension prosthesis for each additional vessel, the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both sides of the body. It indicates that the procedure was conducted bilaterally.
2. Modifier 51 - Multiple Procedures: This modifier is applied when multiple procedures are performed during the same surgical session. It helps in identifying that more than one procedure was carried out.
3. 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 is particularly useful when procedures are not typically reported together but are appropriate under the circumstances.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician. It indicates that the procedure was performed more than once on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician. It signifies that the procedure was performed more than once on the same day by different practitioners.
6. 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 a patient returns to the operating room for a related procedure during the postoperative period of the initial surgery.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
These modifiers help in accurately reporting the circumstances under which the procedure was performed, ensuring appropriate billing and reimbursement. It is important to review the specific payer guidelines as they may have unique requirements for modifier usage.
CPT code 34711 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the policies of the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for services rendered. However, the final decision on whether CPT code 34711 is reimbursed, and at what rate, may vary based on local coverage determinations made by the MAC.
It is essential for healthcare providers to verify the specific reimbursement details with their regional MAC to ensure compliance and accurate billing practices.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 34711, RevFind offers 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
