CPT code 35884 is used for revising a femoral anastomosis with an autogenous vein graft, aiding in accurate procedure documentation.
CPT code 35884 is used to describe the surgical revision of a femoral anastomosis involving an autogenous vein graft. This procedure typically involves the surgical correction or improvement of a connection (anastomosis) between blood vessels in the femoral region, using a vein graft taken from the patient's own body. The revision is necessary when there are complications or issues with the initial graft, such as narrowing or blockage, to ensure proper blood flow and function.
For the CPT code 35884, the following modifiers may be applicable depending on the specific circumstances of the procedure and the billing requirements:
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 circumstances during the surgery.
2. Modifier 51 (Multiple Procedures): Apply this modifier when multiple procedures are performed during the same surgical session. It indicates that the procedure was one of several performed.
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 helps to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 62 (Two Surgeons): If two surgeons are required to perform the procedure due to its complexity, this modifier should be used to indicate that both surgeons were necessary and actively involved.
5. Modifier 66 (Surgical Team): Use this modifier when the procedure requires a surgical team due to its complexity, indicating that multiple professionals were involved in the surgery.
6. Modifier 76 (Repeat Procedure by Same Physician): This modifier is applicable if the same procedure is repeated by the same physician on the same day.
7. Modifier 77 (Repeat Procedure by Another Physician): Use this modifier if the procedure is repeated by a different physician 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 needs to 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): Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): Use this modifier when an assistant surgeon is required to help perform the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when a minimal assistant surgeon is necessary for the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Apply this modifier when an assistant surgeon is needed due to the unavailability of a qualified resident surgeon.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
The CPT code 35884 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 your region.
The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each MAC, which administers Medicare claims for a specific geographic area, may have additional local coverage determinations that affect whether a particular CPT code is reimbursed.
Therefore, it is crucial to verify with your local MAC to ensure that CPT code 35884 is covered and to understand any specific documentation or billing requirements that may apply.
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