CPT code 34845 is used for a procedure involving the placement of a prosthetic device in the abdominal area to support visceral and infrarenal structures.
CPT code 34845 is used to describe a surgical procedure involving the placement of a prosthetic device in the visceral and infrarenal abdominal aorta. This procedure typically involves the repair or reconstruction of the abdominal aorta, which is the large blood vessel that supplies blood to the abdomen, pelvis, and legs. The use of a prosthetic device helps to reinforce or replace the damaged section of the aorta, ensuring proper blood flow and reducing the risk of complications such as aneurysms. This code is specific to procedures that involve one prosthetic device in the specified region of the aorta.
For CPT code 34845, which involves a vascular procedure, 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 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 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 indicates that more than one procedure was conducted.
4. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: If the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier should be applied.
6. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure, this modifier is used.
7. Modifier 66 - Surgical Team: This modifier is applicable when a complex procedure requires the services of several physicians, often of different specialties, working together as a team.
8. Modifier 76 - Repeat Procedure by Same Physician: If the same physician repeats the procedure, this modifier should be used to indicate the repetition.
9. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure is repeated by a different 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 a patient requires a 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: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier should be applied.
12. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: This modifier indicates that a minimum assistant surgeon was necessary for the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required 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 that multiple modifiers apply.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association and payer policies to ensure accurate billing and reimbursement.
CPT code 34845 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the policies set by the Medicare Administrative Contractor (MAC) for your specific region.
The MPFS outlines the payment rates for services covered under Medicare Part B, and CPT code 34845 would need to be listed there to be eligible for reimbursement.
Additionally, MACs have the authority to establish local coverage determinations (LCDs) that can affect whether and how a particular CPT code is reimbursed.
Therefore, it is essential to verify with the relevant MAC for your area to ensure that CPT code 34845 is covered and to understand any specific billing requirements or documentation needed for reimbursement.
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