CPT code 41114 is for the excision of a lesion on the tongue, detailing the specific procedure for billing and documentation in healthcare.
CPT code 41114 is used to describe the surgical procedure involving the excision of a lesion located on the tongue. This code indicates that a healthcare provider has performed a surgical removal of abnormal tissue from the tongue, which may be necessary for diagnostic or therapeutic reasons. The procedure typically involves cutting away the lesion and may include additional steps to ensure proper healing and minimize complications.
When billing for CPT code 41114 (Excision of tongue lesion), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the tongue.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: Used when the procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
7. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
8. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs a procedure or service again on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician on the same day.
10. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used when a related procedure is performed during the postoperative period of the initial procedure.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
12. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required, and a qualified resident surgeon is not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in the surgery.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement.
Determining if CPT code 41114 is reimbursed by Medicare involves consulting the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates. Each MAC may have specific local coverage determinations (LCDs) that can affect whether a particular CPT code is reimbursed in your area.
To verify if CPT code 41114 is reimbursed, you should:
1. Check the MPFS: Access the Medicare Physician Fee Schedule database to see if CPT code 41114 is listed and review the associated reimbursement rate.
2. Consult Your MAC: Review any local coverage determinations (LCDs) or policies issued by your regional MAC, as these can provide additional guidance on coverage criteria and reimbursement specifics.
By following these steps, you can determine if CPT code 41114 is eligible for reimbursement under Medicare.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 41114. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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