CPT code 37204 is used for procedures involving the transcatheter occlusion of blood vessels to treat certain medical conditions.
CPT code 37204 is used to describe the procedure of transcatheter occlusion, which involves the use of a catheter to block or close off a blood vessel. This procedure is typically performed to treat conditions such as aneurysms, arteriovenous malformations, or to stop bleeding. By inserting a catheter through the vascular system, a healthcare provider can deliver materials like coils, plugs, or other occlusive agents directly to the target site, effectively sealing off the vessel without the need for open surgery. This minimally invasive approach is often preferred for its reduced recovery time and lower risk of complications compared to traditional surgical methods.
For the CPT code 37204, "Transcatheter occlusion," the following modifiers may be applicable depending on the specific circumstances of the procedure and the billing requirements:
1. Modifier 26 - Professional Component: This modifier is used when the physician provides only the professional component of the service, such as the interpretation of the procedure, and not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is provided, such as the use of equipment and supplies, without 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 part of a single procedure.
4. Modifier 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same session. It indicates that the procedure is one of several performed on the same day.
5. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
6. Modifier 53 - Discontinued Procedure: This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
7. 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.
8. 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.
9. 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.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period of another procedure.
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 requirements, as these can vary.
CPT code 37204, which pertains to transcatheter occlusion, is no longer reimbursed by Medicare as it has been deleted and replaced by other codes. To determine if a specific CPT code is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing claims and providing guidance on coverage and reimbursement policies for specific CPT codes. It is essential for healthcare providers to consult the MPFS and their respective MACs to verify the current status and reimbursement details of any CPT code.
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