CPT code 34825 is used for the initial placement of an endovascular prosthesis to extend a previous repair of an abdominal aortic aneurysm.
CPT code 34825 is used to describe the initial placement of an extension prosthesis during an endovascular repair of an aortic aneurysm. This procedure involves the insertion of a graft to reinforce the aorta and prevent the aneurysm from rupturing. The code specifically refers to the first extension piece that is placed to ensure the graft fits securely and functions effectively. This is a critical step in the endovascular repair process, as it helps to maintain the structural integrity of the aorta and improve patient outcomes.
For CPT code 34825, which involves endovascular procedures, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both sides of the body during the same operative session.
2. Modifier 51 - Multiple Procedures: This is applicable 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 procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 59 - Distinct Procedural Service: This 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 applicable when two surgeons work together as primary surgeons performing distinct parts of a procedure.
6. Modifier 66 - Surgical Team: This is used when a complex procedure requires the services 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 is applicable when the procedure is repeated by a different physician.
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 is used when a patient requires a 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 modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon: This is used when an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: This modifier is applicable when an assistant surgeon is required for a minimal portion of the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This is used when an assistant surgeon is required, and a qualified resident surgeon is not available.
14. Modifier 99 - Multiple Modifiers: This is used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. It is important to review the specific payer guidelines as they may have additional requirements or restrictions regarding the use of modifiers.
CPT code 34825 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 listing of fees used to reimburse physicians and other healthcare providers on a fee-for-service basis. However, the actual reimbursement for CPT code 34825 can vary depending on the local coverage determinations (LCDs) set by the MAC, which may have specific guidelines or requirements for coverage.
It is essential for healthcare providers to verify the specific reimbursement details with their regional MAC to ensure compliance and proper billing practices.
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