CPT code 34714 is used for procedures involving the open exposure of the femoral artery for conduit creation or cartridge insertion.
CPT code 34714 is used to describe the procedure of open femoral artery exposure for the purpose of inserting or replacing an endovascular prosthesis, such as a stent graft, in the treatment of conditions like aneurysms or blockages. This code specifically refers to the surgical approach where the femoral artery is accessed through an incision to facilitate the placement or adjustment of the endovascular device. This procedure is typically part of a larger endovascular repair process and is crucial for ensuring proper access to the vascular system.
For CPT code 34714, which involves open femoral artery exposure for conduit creation, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or additional work that is not usually part of the procedure.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was performed.
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 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 due to its complexity, this modifier indicates that both surgeons are involved in the procedure.
6. Modifier 66 - Surgical Team: This is used when a team of surgeons is required to perform the procedure due to its complexity.
7. Modifier 76 - Repeat Procedure by Same Physician: If the same physician repeats the procedure on the same day, this modifier is applicable.
8. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure is repeated by another physician on the same day.
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 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 consult the latest CPT coding guidelines and payer-specific policies to confirm the appropriate use of modifiers.
To determine if CPT code 34714 is reimbursed by Medicare, one must refer to the Medicare Physician Fee Schedule (MPFS) and consult with the relevant Medicare Administrative Contractor (MAC) for the specific region. The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each year, the Centers for Medicare & Medicaid Services (CMS) updates the MPFS, which includes information on whether specific CPT codes are covered and the reimbursement rates.
CPT code 34714 may be included in the MPFS, but its reimbursement status can vary based on several factors, including the setting in which the service is provided and any local coverage determinations (LCDs) made by the MAC. MACs are responsible for processing Medicare claims and have the authority to make coverage decisions that can affect whether a particular CPT code is reimbursed in their jurisdiction.
Healthcare providers should verify the reimbursement status of CPT code 34714 by checking the latest MPFS and consulting with their regional MAC. This ensures that they have the most accurate and up-to-date information regarding Medicare reimbursement for this specific code.
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