CPT code 37248 is used for transluminal balloon angioplasty of the first vein, a procedure to widen narrowed or obstructed veins.
CPT code 37248 is used to describe a transluminal balloon angioplasty procedure performed on the first vein. This code is specifically utilized when a healthcare provider uses a balloon catheter to open up a narrowed or blocked vein, improving blood flow. The procedure is minimally invasive and typically involves inserting the catheter through a small incision, guiding it to the affected vein, and inflating the balloon to widen the vein. This code is essential for accurately documenting and billing for the angioplasty of the first vein treated during the session.
For CPT code 37248, which pertains to transluminal balloon angioplasty of the first vein, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the professional component of the service is being billed separately from the technical component. It is applicable if the physician is providing only the interpretation of the procedure.
2. Modifier TC - Technical Component: This modifier is used when the technical component of the service is being billed separately from the professional component. It is applicable if the facility is billing for the use of equipment and supplies.
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 may be necessary if multiple procedures are performed and need to be reported separately.
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. It may apply if the full service described by the CPT code was not performed.
6. Modifier 53 - Discontinued Procedure: This modifier is used when a procedure is 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: 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.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always consult the latest coding guidelines and payer-specific requirements when applying modifiers.
CPT code 37248 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for services rendered. Each MAC, which is responsible for processing Medicare claims, may have specific local coverage determinations (LCDs) that affect whether CPT code 37248 is reimbursed in your area.
Therefore, it is crucial for healthcare providers to verify the reimbursement status of CPT code 37248 with their respective MAC and review any relevant LCDs to ensure compliance and proper billing practices.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments down to the CPT code level, including specific codes like 37248. Schedule a demo today to see how RevFind can help you maximize reimbursements from each payer.
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