CPT code 37140 is a procedure for revising blood flow in the body, often used to improve or restore proper circulation.
CPT code 37140 is used to describe a medical procedure involving the revision of circulation. This typically refers to a surgical intervention aimed at correcting or improving blood flow within the body. Such procedures are often necessary when there are issues like blockages, narrowing, or other abnormalities in the blood vessels that impede proper circulation. The revision may involve techniques such as bypass grafting, angioplasty, or other vascular surgical methods to restore adequate blood flow and ensure the circulatory system functions effectively. This code is crucial for healthcare providers to accurately document and bill for the specific services rendered during the procedure.
For CPT code 37140, "Revision of circulation," the following modifiers may be applicable depending on the specific circumstances of the procedure:
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 52 - Reduced Services: Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion. Documentation should support the reason for the reduction.
4. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to identify procedures that are not normally reported together but are appropriate under the circumstances.
5. 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.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Use this modifier when the same procedure is repeated by a different provider on the same day.
7. 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 related procedure is performed during the postoperative period of the initial procedure.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Apply this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Use this modifier when a minimum assistant surgeon is required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required, and a qualified resident surgeon is not available.
12. Modifier 99 - Multiple Modifiers: Use this modifier when two or more modifiers are necessary to describe the service provided.
Each modifier should be used in accordance with the specific circumstances of the procedure and the payer's guidelines. Proper documentation is essential to support the use of any modifier.
The CPT code 37140 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.
The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers on a fee-for-service basis. Each CPT code listed in the MPFS has an assigned relative value unit (RVU) that determines the reimbursement rate. To determine if CPT code 37140 is reimbursed, you would need to check its status in the current MPFS. If it is listed, it will have an associated RVU and reimbursement rate.
Additionally, MACs, which are private health insurers contracted by Medicare to process claims, may have specific local coverage determinations (LCDs) that affect whether CPT code 37140 is reimbursed. These LCDs can vary by region and may include additional criteria or documentation requirements for reimbursement.
Therefore, to confirm if CPT code 37140 is reimbursed by Medicare, healthcare providers should review the current MPFS and consult with their regional MAC for any applicable LCDs or additional guidelines.
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