CPT code 35633 is used for a surgical procedure involving an arterial bypass from the iliac to the mesenteric artery.
CPT code 35633 is used to describe a surgical procedure known as an "arterial bypass from the iliac artery to the mesenteric artery." This procedure involves creating a bypass to redirect blood flow from the iliac artery, which supplies blood to the lower limbs, to the mesenteric artery, which supplies blood to the intestines. This type of surgery is typically performed to improve blood flow to the abdominal organs when there is a blockage or narrowing in the existing arteries, helping to prevent complications such as intestinal ischemia.
For CPT code 35633, which pertains to arterial bypass procedures, the following modifiers may be applicable. These modifiers are used to provide additional information about the performed procedure and ensure accurate billing and reimbursement:
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 increased complexity or difficulty of the procedure.
2. Modifier 51 - Multiple Procedures: This modifier is applicable when multiple procedures are performed during the same surgical session. It indicates that the procedure was performed in conjunction with other procedures.
3. 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. It helps to clarify that the procedures are not components of a more comprehensive service.
4. Modifier 62 - Two Surgeons: This modifier is used when two surgeons work together as primary surgeons performing distinct parts of a procedure. Each surgeon should report their distinct operative work.
5. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires the services of a surgical team, indicating that multiple professionals are involved in the surgery.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider on the same day.
8. 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.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure performed during the postoperative period is unrelated to the original procedure.
These modifiers help in providing a comprehensive picture of the services rendered and ensure that healthcare providers receive appropriate reimbursement for their services. Proper use of modifiers is crucial in avoiding claim denials and ensuring compliance with payer requirements.
The CPT code 35633 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 forth by the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for services rendered. However, the actual reimbursement for CPT code 35633 can vary based on local coverage determinations (LCDs) and national coverage determinations (NCDs) established by the MAC.
It is essential for healthcare providers to verify the specific guidelines and reimbursement rates with their regional MAC to ensure compliance and accurate billing practices.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 35633, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and enhance your revenue cycle management.
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
