CPT code 34847 is used for a procedure involving the placement of three prosthetic devices in the visceral and infrarenal abdominal area.
CPT code 34847 is used to describe a specific endovascular procedure involving the placement of three prosthetic devices in the visceral and infrarenal abdominal aorta. This code is typically utilized during complex aortic aneurysm repairs where multiple stent grafts are required to reinforce the aorta and prevent rupture. The procedure is performed by a vascular surgeon and involves navigating through the blood vessels to position the prosthetics accurately, ensuring proper blood flow and structural support. This code is essential for billing and documentation purposes, allowing healthcare providers to accurately report the complexity and resources involved in such advanced surgical interventions.
For CPT code 34847, which involves a complex procedure related to vascular surgery, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used, along with the reasons for their application:
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 the procedure was bilateral.
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 carried out.
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 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.
6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, this modifier indicates that each surgeon is performing a distinct part of the procedure.
7. Modifier 66 - Surgical Team: This modifier is used when a team of surgeons is required to perform the procedure due to its complexity.
8. 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.
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 is used when a 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 a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
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 proper documentation in the patient's medical record.
The CPT code 34847 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource for determining if a specific CPT code is reimbursed by Medicare. The MPFS outlines the payment rates for services and procedures covered by Medicare Part B, and it is updated annually to reflect changes in policy and reimbursement rates.
For CPT code 34847, you would need to consult the MPFS to verify if it is listed and what the associated reimbursement rate might be. Additionally, Medicare Administrative Contractors (MACs) play a significant role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to make local coverage determinations (LCDs) that can affect whether a particular service or procedure is reimbursed in their jurisdiction.
Therefore, to determine if CPT code 34847 is reimbursed by Medicare, healthcare providers should review the MPFS for the current year and consult with their respective MAC to understand any local coverage policies that may apply. This ensures that providers have the most accurate and up-to-date information regarding reimbursement for this specific code.
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