CPT code 35702 is used for describing the exploration of a neck or upper extremity artery during surgical procedures.
CPT code 35702 is used to describe the exploration of a blood vessel in the upper extremity, such as an artery, to assess its condition or to follow up after a surgical procedure. This code is typically utilized when a surgeon needs to examine the blood vessel to ensure proper blood flow or to identify any potential issues that may have arisen post-surgery. The procedure involves making an incision to access the vessel, allowing the surgeon to visually inspect and, if necessary, address any complications like blockages or leaks. This code is crucial for documenting the surgical exploration process and ensuring accurate billing and reimbursement for the healthcare provider.
For CPT code 35702, which involves exploration and/or follow-up surgery of upper extremity arteries, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or unexpected findings during surgery.
2. Modifier 50 (Bilateral Procedure): If the procedure is performed on both upper extremities during the same session, this modifier should be applied to indicate a bilateral procedure.
3. Modifier 51 (Multiple Procedures): When multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was carried out.
4. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day. It is often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier 62 (Two Surgeons): If two surgeons are required to perform distinct parts of the procedure, this modifier should be used to indicate the collaborative effort.
6. Modifier 66 (Surgical Team): When a complex procedure requires a surgical team, this modifier is used to denote the involvement of multiple specialists.
7. Modifier 76 (Repeat Procedure by Same Physician): If the same procedure needs to be repeated by the same physician, this modifier is used to indicate the repetition.
8. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when the procedure is repeated by a different physician.
9. 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 applicable.
10. Modifier 79 (Unrelated Procedure or Service by the Same Physician): Use this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always refer to the latest CPT and payer guidelines for specific usage and documentation requirements.
CPT code 35702 is subject to reimbursement by Medicare, but its eligibility for payment depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) for the region in which the service is provided.
The MPFS determines the payment rates for services covered under Medicare Part B, and it is essential to verify whether CPT code 35702 is listed and the associated reimbursement rate.
Additionally, MACs have the authority to interpret national policies and may have local coverage determinations (LCDs) that affect the reimbursement of specific CPT codes.
Therefore, healthcare providers should consult the MPFS and their regional MAC to confirm the reimbursement status of CPT code 35702.
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