CPT code 34844 is used for a procedure involving the placement of an endovascular graft in the visceral aorta, typically to repair aneurysms.
CPT code 34844 is used to describe a specific endovascular procedure involving the visceral aorta. This code is applied when a healthcare provider performs a repair or replacement of the visceral aorta using four or more endovascular grafts. The procedure is typically done to address aneurysms or other vascular conditions affecting the visceral segment of the aorta, which supplies blood to the abdominal organs. The use of multiple grafts indicates a complex intervention aimed at restoring proper blood flow and ensuring the structural integrity of the aorta. This code is crucial for accurate billing and documentation of the procedure in the healthcare revenue cycle.
For CPT code 34844, which pertains to endovascular procedures involving the aorta, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and their uses:
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 was not anticipated.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be used to indicate that it was a bilateral procedure.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.
4. Modifier 52 - Reduced Services: This modifier is applicable when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. 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.
6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier is used to indicate that both surgeons were necessary.
7. Modifier 66 - Surgical Team: When a team of surgeons is required to perform the procedure, this modifier is used to indicate the involvement of a surgical team.
8. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure, this modifier is used to indicate that it was necessary to perform the procedure again.
9. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the procedure, this modifier is used to indicate that the repeat procedure was performed by someone other than the original physician.
10. 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.
11. 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 of the initial procedure.
12. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier is used to indicate their involvement.
13. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
15. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier is used to indicate the use of multiple modifiers.
These modifiers help provide additional information about the circumstances under which the procedure was performed, which can be crucial for accurate billing and reimbursement. Always ensure that the use of modifiers is supported by the documentation in the patient's medical record.
CPT code 34844 is subject to reimbursement by 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 forth by the Medicare Administrative Contractor (MAC) in your region.
The MPFS provides a comprehensive list of services and procedures that Medicare reimburses, along with the associated payment rates. However, coverage can vary based on local policies established by the MAC, which is responsible for processing Medicare claims and providing guidance on coverage decisions.
Therefore, it is essential for healthcare providers to verify the specific reimbursement details for CPT code 34844 with their local MAC to ensure compliance with Medicare's billing requirements and to determine the exact reimbursement rate.
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