CPT code 35301 is used for the procedure involving the rechanneling of an artery to improve blood flow and restore proper circulation.
CPT code 35301 is used to describe a surgical procedure known as the rechanneling of an artery. This procedure involves the removal of blockages or obstructions within an artery to restore normal blood flow. It is typically performed to treat conditions such as peripheral artery disease, where plaque buildup restricts blood circulation. The rechanneling process may involve techniques like endarterectomy, where the inner lining of the artery is cleaned out, or bypass grafting, where a new pathway is created for blood to flow around the blockage. This code is crucial for healthcare providers to accurately document and bill for the surgical intervention aimed at improving vascular health.
For CPT code 35301, which involves the rechanneling of an artery, 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. Documentation must support the substantial additional work and the reason for it.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier indicates that the procedure was performed bilaterally.
3. Modifier 51 - Multiple Procedures: This is used when multiple procedures are performed during the same surgical session. It indicates that more than one procedure was performed.
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 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, this modifier indicates that both surgeons worked together as primary surgeons.
7. Modifier 66 - Surgical Team: This 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: This modifier is used when the same procedure is repeated by the same physician.
9. Modifier 77 - Repeat Procedure by Another Physician: This is used when the same 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 returns 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 indicates that a procedure performed during the postoperative period was unrelated to the original procedure.
12. Modifier 80 - Assistant Surgeon: This is used when an assistant surgeon is required for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: This indicates that a minimum assistant surgeon was required for the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
15. Modifier 99 - Multiple Modifiers: This is used when two or more modifiers are necessary to describe the service provided.
Each modifier serves a specific purpose and should be used in accordance with the guidelines set forth by the American Medical Association (AMA) and payer policies. Proper documentation is essential to support the use of any modifier.
CPT code 35301 is reimbursed by Medicare, but the reimbursement is subject to several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered under Medicare Part B, including surgical procedures like those associated with CPT code 35301. The reimbursement amount can vary based on geographic location, as determined by the Medicare Administrative Contractor (MAC) responsible for processing claims in a specific region. Each MAC may have different local coverage determinations (LCDs) that can affect whether and how a particular service is reimbursed. Therefore, it is essential for healthcare providers to verify the specific reimbursement details for CPT code 35301 with their respective MAC and consult the MPFS for the most accurate and up-to-date payment information.
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