CPT code 34718 is used for reporting endovascular repair of an aorto-iliac artery with a non-dedicated graft.
CPT code 34718 is used to describe an endovascular repair procedure involving the iliac artery, specifically when a non-aortoiliac endograft is utilized. This code is typically applied when a healthcare provider performs a minimally invasive procedure to repair or reinforce the iliac artery, which is a major blood vessel in the pelvis, using a specialized graft that does not involve the aorta. This procedure is often indicated for patients with conditions such as aneurysms or other vascular abnormalities in the iliac artery, aiming to restore proper blood flow and prevent complications.
For CPT code 34718, which involves endovascular repair procedures, 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 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 helps in identifying that more than one procedure was carried out.
3. Modifier 52 - Reduced Services: This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion. It indicates that the service provided was less than usually required.
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. It is often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier 62 - Two Surgeons: This modifier is applicable when two surgeons work together as primary surgeons performing distinct parts of a procedure. Each surgeon should report their distinct operative work.
6. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires the skills of several physicians, often of different specialties, working together as a 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 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 modifier is used when a procedure performed during the postoperative period is unrelated to the original procedure.
These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 34718 is subject to reimbursement by Medicare, but its reimbursement is contingent upon several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) in your region.
The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service. However, the final determination of reimbursement can vary based on local coverage determinations (LCDs) and the specific policies of the MAC that administers Medicare claims in your area.
Therefore, it is essential for healthcare providers to verify the coverage and reimbursement details for CPT code 34718 with their respective MAC to ensure compliance and proper billing practices.
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