CPT code 34806 is used for the procedure of adding an aneurysm pressure sensor, which helps monitor and manage aneurysm treatment effectively.
CPT code 34806 is an add-on code used to describe the placement of an aneurysm pressure sensor during endovascular aneurysm repair (EVAR). This procedure involves inserting a sensor to monitor the pressure within an aneurysm sac, which helps in assessing the effectiveness of the repair and ensuring that the aneurysm is not at risk of rupture. The code is used in conjunction with the primary procedure code for the EVAR, indicating that the pressure sensor placement is an additional service provided during the surgery.
For CPT code 34806, which pertains to an aneurysm press sensor add-on, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided involves only the professional component, such as the interpretation of the sensor data, separate from the technical component.
2. Modifier 51 - Multiple Procedures: If the aneurysm press sensor add-on is performed in conjunction with other procedures, this modifier indicates that multiple procedures were performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the aneurysm press sensor add-on is a distinct service from other procedures performed on the same day, which may not typically be reported together.
4. Modifier 62 - Two Surgeons: If two surgeons are involved in the procedure, each performing distinct parts of the operation, this modifier is used to indicate the shared responsibility.
5. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to perform the aneurysm press sensor add-on more than once on the same day, this modifier is used to denote the repeat service.
6. Modifier 77 - Repeat Procedure by Another Physician: If a different physician performs the aneurysm press sensor add-on on the same day, this modifier is used to indicate the repeat service by another provider.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room: If the patient requires an unplanned return to the operating room for a related procedure during the postoperative period, this modifier is applicable.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when the aneurysm press sensor add-on is performed during the postoperative period of another procedure but is unrelated to the original surgery.
9. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier indicates their involvement.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
These modifiers help provide additional information about the circumstances under which the aneurysm press sensor add-on was performed, ensuring accurate billing and reimbursement.
CPT code 34806, which is an add-on code, is subject to reimbursement considerations under Medicare. To determine if this specific CPT code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with their respective reimbursement rates.
Additionally, it is important to consult with the local Medicare Administrative Contractor (MAC), as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 34806. MACs may have regional variations in their policies, so checking with the appropriate MAC ensures that providers have the most accurate and up-to-date information regarding reimbursement for this code.
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