CPT code 37202 is used for procedures involving the infusion of therapeutic agents through a catheter to treat specific medical conditions.
CPT code 37202 is used to describe a medical procedure involving transcatheter therapy infusion. This code is specifically applied when a healthcare provider administers therapeutic agents directly into a patient's blood vessels using a catheter. The procedure is typically performed to deliver medications or other therapeutic substances directly to a targeted area, often to treat conditions such as blood clots, tumors, or vascular malformations. The use of a catheter allows for precise delivery of the therapy, minimizing systemic exposure and potentially reducing side effects.
For CPT code 37202, which involves transcatheter therapy infusion, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for the interpretation of the procedure, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the equipment, supplies, and technical support, excluding the professional interpretation.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to prevent bundling of services that are typically considered inclusive.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day. It indicates that the procedure was necessary to be performed again.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day. It indicates that the procedure was necessary to be performed again by another provider.
6. 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 requires a return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
8. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required during the procedure. It indicates that another surgeon assisted in the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when an assistant surgeon is required for a minimal portion of the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because 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 verify with the latest coding guidelines and payer-specific policies, as requirements can vary.
CPT code 37202 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers on a fee-for-service basis. Whether CPT code 37202 is reimbursed by Medicare can depend on several factors, including the specific circumstances of the service provided and the local coverage determinations made by the Medicare Administrative Contractor (MAC) for the region where the service is rendered.
MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that can affect the reimbursement of specific CPT codes. Therefore, while CPT code 37202 may be listed on the MPFS, its reimbursement is contingent upon the guidelines and policies set forth by the relevant MAC. Providers should consult the MPFS and their regional MAC's LCDs to determine the specific reimbursement status and any applicable conditions for CPT code 37202.
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