CPT code 35883 is used for revising a femoral anastomosis with a non-autologous graft, aiding in accurate procedure documentation.
CPT code 35883 is used to describe the surgical revision of a femoral artery anastomosis involving a non-autogenous graft. This procedure typically involves correcting or modifying the connection between the femoral artery and a graft that is not derived from the patient's own tissue. Such revisions may be necessary to address complications like blockages or leaks in the graft, ensuring proper blood flow and graft function. This code is crucial for accurate billing and documentation of the specific surgical intervention performed.
For CPT code 35883, which involves revision of a femoral anastomosis with a non-autogenous graft, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if 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 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.
3. Modifier 59 - Distinct Procedural Service: Apply this modifier to indicate that the procedure is distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: Use this modifier if the procedure needs to be repeated by the same provider.
5. 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 applicable if the patient returns to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier when the procedure is performed by the same physician during the postoperative period of another procedure, but is unrelated to the original procedure.
7. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
8. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Similar to Modifier 80, but specifically used when a qualified resident surgeon is not available.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always ensure that documentation supports the use of any modifier applied.
The CPT code 35883 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) in your region.
To determine if CPT code 35883 is reimbursed by Medicare, you would first need to consult the MPFS. The MPFS provides a comprehensive list of services covered by Medicare, along with the associated reimbursement rates. If CPT code 35883 is listed in the MPFS, it indicates that Medicare has established a reimbursement rate for this service, subject to meeting all necessary billing and documentation requirements.
Additionally, the MAC, which administers Medicare claims for your geographic area, may have specific local coverage determinations (LCDs) or policies that affect the reimbursement of CPT code 35883. These policies can vary by region and may include additional criteria that must be met for the service to be covered.
Therefore, to confirm reimbursement for CPT code 35883, healthcare providers should review the MPFS for the current year and consult with their regional MAC to ensure compliance with any local policies or requirements.
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