CPT code 37252 is used for intravascular ultrasound procedures on non-coronary vessels, specifically for the first vessel examined.
CPT code 37252 is used to describe the procedure of intravascular ultrasound (IVUS) for non-coronary vessels, specifically for the first vessel examined. This code is typically utilized when a healthcare provider uses ultrasound technology to visualize the inside of blood vessels that are not part of the coronary system, such as peripheral arteries or veins. The procedure helps in assessing the vessel's condition, identifying blockages, or evaluating the effectiveness of treatments like angioplasty or stenting. This code is essential for accurate billing and documentation of the use of IVUS in non-coronary vascular procedures.
For CPT code 37252, which involves intravascular ultrasound (IVUS) for non-coronary vessels, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component only, such as the interpretation of the IVUS results by a physician.
2. Modifier TC - Technical Component: This modifier is used when the service provided is the technical component only, such as the use of the equipment and the technician's work.
3. Modifier 59 - Distinct Procedural Service: This modifier may be used if the IVUS is performed as a distinct service from other procedures on the same day, indicating that it is not a routine part of another procedure.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is applicable if the IVUS procedure needs to be repeated on the same day by the same provider.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used if the IVUS procedure is repeated on the same day by a different 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 if the IVUS is performed again during the postoperative period due to complications or related issues.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if the IVUS is performed during the postoperative period but is unrelated to the original procedure.
These modifiers help clarify the circumstances under which the IVUS procedure was performed and ensure accurate billing and reimbursement. It is important to use the appropriate modifier to reflect the specific scenario accurately.
CPT code 37252 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 policies of the local Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive listing of fees used to reimburse physicians and other healthcare providers on a fee-for-service basis. However, the final decision on whether CPT code 37252 is reimbursed can vary depending on the specific guidelines and coverage determinations set forth by the MAC in your region.
It is crucial for healthcare providers to verify the reimbursement status of this code with their local MAC to ensure compliance and proper billing practices.
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