CPT CODES

CPT Code 34712

CPT code 34712 is used for reporting the delivery of an enhanced fixation device during a medical procedure.

Table of Contents
What is CPT Code 34712
Does CPT 34712 Need a Modifier?
CPT Code 34712 Medicare Reimbursement
Are You Being Underpaid for 34712 CPT Code?
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What is CPT Code 34712

CPT code 34712 is used to describe the procedure of delivering an enhanced fixation device during endovascular repair. This code is typically utilized in the context of vascular surgery, where a physician places a specialized device to secure a stent graft within a blood vessel. The enhanced fixation device is designed to improve the stability and positioning of the stent graft, ensuring it remains securely in place to effectively treat conditions such as aneurysms. This code is important for accurate billing and documentation of the specific techniques and devices used in complex vascular procedures.

Does CPT 34712 Need a Modifier?

For CPT code 34712, the following modifiers may be applicable depending on the specific circumstances of the procedure and the billing requirements:

1. Modifier 50 - Bilateral Procedure: This modifier is used when the procedure is performed on both sides of the body during the same operative session.

2. Modifier 51 - Multiple Procedures: This modifier is applied when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.

3. Modifier 52 - Reduced Services: This modifier is used when the service or 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: This modifier is used when two surgeons work together as primary surgeons performing distinct parts of a procedure.

6. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires the services of a surgical team.

7. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician subsequent to the original procedure.

8. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician subsequent to the original procedure.

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 a related procedure is performed during the postoperative period of the initial procedure.

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.

11. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.

12. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when an assistant surgeon is required for a portion of the procedure.

13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required and a qualified resident surgeon is not available.

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 34712 Medicare Reimbursement

To determine if the CPT code 34712 is reimbursed by Medicare, one must consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the respective Medicare Administrative Contractor (MAC) for the region. The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. It includes information on whether specific CPT codes are covered and the reimbursement rates.

For CPT code 34712, you would first check the MPFS to see if it is listed and if it has an associated reimbursement rate. If the code is present in the MPFS, it indicates that Medicare recognizes the code and provides reimbursement, subject to any specific conditions or limitations.

Additionally, it is important to verify with the local MAC, as they have the authority to interpret Medicare policies and may have additional guidelines or requirements for reimbursement. MACs can provide region-specific information that might affect whether a particular service is covered or how it is reimbursed.

In summary, to confirm if CPT code 34712 is reimbursed by Medicare, healthcare providers should review the MPFS and consult with their local MAC for any additional coverage details or requirements.

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