CPT code 34832 is used for the procedure involving the open repair of an aortofemoral prosthetic graft, typically addressing complications.
CPT code 34832 is used to describe the surgical procedure for the open repair of an aortofemoral prosthetic graft. This procedure involves the surgical correction or replacement of a previously placed prosthetic graft that connects the aorta to the femoral artery. Such repairs are typically necessary when there are complications such as graft infection, blockage, or other issues that compromise the function of the graft. The procedure is performed by a vascular surgeon and requires precise surgical techniques to ensure proper blood flow is restored and maintained.
For the CPT code 34832, which pertains to open aortofemoral prosthetic repair, 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 other factors that increase the complexity of the procedure.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that the procedure is one of several performed.
3. Modifier 52 - Reduced Services: This modifier 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. It is used to identify procedures that are not typically reported together but are appropriate under the circumstances.
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 actively involved in the procedure.
6. Modifier 66 - Surgical Team: This modifier 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 needs to repeat the procedure, this modifier is used to indicate that the procedure was repeated.
8. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a 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 modifier is used when 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 modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
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 guidelines and payer policies when applying these modifiers to ensure compliance and proper reimbursement.
CPT code 34832 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set 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, coverage can vary based on local policies established by MACs, which are responsible for processing Medicare claims and determining coverage specifics in different geographic areas.
Therefore, to determine if CPT code 34832 is reimbursed by Medicare, healthcare providers should consult the MPFS for the current year and verify with their local MAC for any additional coverage criteria or restrictions that may apply.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including CPT code 34832, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and enhance your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
