CPT code 35840 is used for procedures involving the exploration of abdominal blood vessels to diagnose or treat vascular conditions.
CPT code 35840 is used to describe the surgical procedure of exploring the abdominal vessels. This code is typically utilized when a healthcare provider needs to examine the blood vessels within the abdominal cavity to identify any abnormalities, blockages, or other issues that may require further intervention. The exploration may involve making an incision to access the vessels and could be part of a larger surgical procedure or a standalone diagnostic exploration. This code is crucial for accurate billing and documentation, ensuring that the healthcare provider is reimbursed appropriately for the complexity and resources involved in performing this procedure.
For CPT code 35840, which involves the exploration of abdominal vessels, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 (Increased Procedural Services): This modifier can be used if the procedure required significantly more work than typically required. This could be due to unusual anatomy or complications that arose during the exploration.
2. Modifier 51 (Multiple Procedures): If the exploration of abdominal vessels is performed in conjunction with other procedures during the same surgical session, this modifier may be applied to indicate multiple procedures.
3. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day. It is applicable when the exploration is performed in a separate anatomical site or through a separate incision.
4. Modifier 62 (Two Surgeons): If two surgeons are required to perform the procedure due to its complexity, this modifier can be used to indicate that both surgeons are actively involved and each is performing a distinct part of the procedure.
5. Modifier 66 (Surgical Team): In cases where the procedure is so complex that it requires a surgical team, this modifier is used to indicate that multiple professionals are involved in the surgery.
6. Modifier 78 (Unplanned Return to the Operating/Procedure Room): If the patient requires an unplanned return to the operating room for a related procedure during the postoperative period, this modifier may be applied.
7. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used if the exploration is performed during the postoperative period of another procedure but is unrelated to the initial surgery.
These modifiers help provide additional context to the billing and coding process, ensuring accurate reimbursement and documentation of the services provided. It's important for healthcare providers to carefully assess the specifics of each case to determine the appropriate modifiers to use.
The CPT code 35840 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors. The Medicare Physician Fee Schedule (MPFS) plays a crucial role in establishing the reimbursement rates for services covered under Medicare Part B, including those associated with CPT codes. However, whether CPT code 35840 is reimbursed can also depend on the specific guidelines and policies set forth by the Medicare Administrative Contractor (MAC) that services your geographic region. MACs are responsible for interpreting national Medicare policies and may have local coverage determinations (LCDs) that affect the reimbursement of certain procedures. Therefore, it is essential for healthcare providers to consult the MPFS and their respective MAC to confirm the reimbursement status and any specific requirements for CPT code 35840.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level, including CPT code 35840, and by individual payer. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.
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
