CPT code 37217 is used for the procedure involving the placement of a stent in the carotid artery through a retrograde approach.
CPT code 37217 is used to describe the procedure of placing a stent in the carotid artery through a retrograde approach. This procedure is typically performed to treat carotid artery stenosis, which is a narrowing of the carotid arteries that can lead to reduced blood flow to the brain and increase the risk of stroke. The retrograde approach involves accessing the artery in a direction opposite to the normal blood flow, often through a small incision in the neck. This code is crucial for accurate billing and documentation of the procedure, ensuring that healthcare providers are reimbursed appropriately for their services.
For CPT code 37217, which involves stent placement in the retrograde carotid artery, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 26 - Professional Component: This modifier is used when the physician provides only the professional component of the service, such as interpretation of the procedure, and not the technical component.
2. Modifier 50 - Bilateral Procedure: If the stent placement is performed on both carotid arteries during the same session, this modifier indicates that the procedure was bilateral.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the physician's discretion, this modifier is used to indicate that the service provided was less than usually required.
5. 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.
6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier indicates that each surgeon performed a distinct part of the procedure.
7. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure on the same day, this modifier is used to indicate the repeat service.
8. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the procedure on the same day, this modifier is used to indicate the repeat service by another provider.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room: If the patient needs to return to the operating room for a related procedure during the postoperative period, this modifier is used.
10. 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.
11. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier indicates the involvement of an assistant.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary 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. It's important to select the appropriate modifiers based on the specific details of the procedure and the payer's guidelines.
CPT code 37217, which involves a specific medical procedure, is subject to reimbursement considerations under Medicare. To determine if this code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the associated reimbursement rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in interpreting and implementing Medicare policies at the regional level. They may have specific guidelines or coverage determinations that affect whether CPT code 37217 is reimbursed in a particular area. Therefore, healthcare providers should review the MPFS and consult their local MAC to confirm the reimbursement status of CPT code 37217.
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