CPT code 35141 is used for procedures involving the repair of an artery defect, ensuring accurate procedure documentation and reimbursement.
CPT code 35141 is used to describe the surgical procedure for repairing a defect in an artery. This code is specifically applied when a surgeon performs a direct repair on an artery that has been damaged or has a defect, such as an aneurysm or a tear. The procedure involves techniques to restore the integrity and function of the artery, ensuring proper blood flow and reducing the risk of complications. This code is essential for accurate billing and documentation in the healthcare revenue cycle, as it helps healthcare providers communicate the specific services rendered to insurance companies for reimbursement purposes.
For CPT code 35141, which pertains to the repair of a defect in an artery, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the procedure required significantly more work than typically required. This could be due to unusual anatomy or complications that arose during the surgery.
2. Modifier 50 (Bilateral Procedure): If the arterial repair was performed on both sides of the body during the same surgical session, this modifier should be applied.
3. Modifier 51 (Multiple Procedures): When multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was performed.
4. Modifier 52 (Reduced Services): If the procedure was partially reduced or eliminated at the discretion of the physician, this modifier should be used.
5. Modifier 59 (Distinct Procedural Service): Apply this modifier when the procedure is distinct or independent from other services performed on the same day.
6. Modifier 62 (Two Surgeons): If two surgeons were required to perform the procedure, each performing distinct parts of the surgery, this modifier is appropriate.
7. Modifier 66 (Surgical Team): Use this modifier when the procedure requires a team of surgeons due to its complexity.
8. Modifier 76 (Repeat Procedure by Same Physician): If the same physician needs to repeat the procedure on the same day, this modifier should be used.
9. Modifier 77 (Repeat Procedure by Another Physician): When a different physician repeats the procedure on the same day, this modifier is applicable.
10. Modifier 78 (Unplanned Return to the Operating/Procedure Room): If the patient needs to return to the operating room for a related procedure during the postoperative period, this modifier is used.
11. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
12. Modifier 80 (Assistant Surgeon): If an assistant surgeon was necessary for the procedure, this modifier should be applied.
13. Modifier 81 (Minimum Assistant Surgeon): Use this modifier when a minimum assistant surgeon was 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 due to the unavailability of a qualified resident surgeon.
15. Modifier 99 (Multiple Modifiers): When more than four modifiers are necessary to describe the service, this modifier indicates that multiple modifiers are applicable.
Each modifier should be used in accordance with the specific circumstances of the procedure and payer requirements. Proper documentation is essential to support the use of any modifier.
CPT code 35141, which involves the repair of a defect in an artery, is subject to reimbursement by Medicare, but this is contingent upon several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that determines the reimbursement rates for services covered under Medicare Part B. To ascertain if CPT code 35141 is reimbursed, healthcare providers should consult the MPFS to verify if the code is listed and to understand the associated payment rates.
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 establish local coverage determinations (LCDs) that may affect the reimbursement of specific CPT codes. Therefore, it is essential for healthcare providers to check with their respective MAC to ensure that CPT code 35141 is covered and to understand any specific documentation or medical necessity requirements that may apply.
In summary, while CPT code 35141 can be reimbursed by Medicare, providers must verify its inclusion in the MPFS and consult their MAC for any additional guidelines or requirements to ensure proper reimbursement.
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 specific codes like 35141, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and maximize your revenue.
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
