CPT code 34900 is used for a procedure involving the repair of the iliac artery using an endovascular graft.
CPT code 34900 is used to describe an endovascular repair procedure of the iliac artery using a graft. This code is specifically for a minimally invasive technique where a graft is placed within the iliac artery to repair or reinforce it, often due to an aneurysm or other vascular condition. The procedure involves accessing the artery through a small incision and using imaging guidance to position the graft accurately, thereby restoring proper blood flow and preventing potential complications associated with arterial damage.
For CPT code 34900, which pertains to endovascular iliac repair with graft, the following modifiers may be applicable depending on the specific circumstances of the procedure:
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: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.
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 modifier is applied to indicate that a procedure or service was distinct or independent from other services performed on the same day.
5. 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.
6. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires the expertise of a surgical team.
7. Modifier 76 - Repeat Procedure by Same Physician: If the same physician repeats the procedure on the same day, this modifier is used.
8. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure is repeated by a different physician on the same day.
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 if 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 an unrelated procedure is performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: This modifier indicates that a minimum assistant surgeon was necessary for the procedure.
13. 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.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 34900 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 set by the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare will pay for each service, and it is updated annually to reflect changes in practice costs and other factors.
However, the final decision on whether CPT code 34900 is reimbursed can also depend on the local coverage determinations (LCDs) made by your MAC.
These contractors have the authority to interpret national policies and establish specific guidelines for services covered within their jurisdiction.
Therefore, it is crucial to consult the MPFS and your regional MAC's guidelines to confirm the reimbursement status of CPT code 34900.
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