CPT code 41805 is for the removal of a foreign body from the gum, helping healthcare providers accurately bill for this specific procedure.
CPT code 41805 is used to describe the procedure for the removal of a foreign body from the gum tissue. This code is applicable when a healthcare provider performs a surgical intervention to extract an object that has become lodged in the gum area, which may cause discomfort or potential complications for the patient.
For CPT code 41805, "Removal foreign body gum," the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more effort or time than typically required for the removal of a foreign body from the gum.
2. Modifier 52 - Reduced Services: Apply this modifier if the procedure was partially reduced or eliminated at the discretion of the healthcare provider.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the removal of the foreign body was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same physician needs to perform the removal procedure again on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Apply this modifier if a different physician needs to perform the removal procedure again on the same day.
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 patient needs to return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if the removal of the foreign body is unrelated to the original procedure performed during the postoperative period.
8. Modifier 80 - Assistant Surgeon: Apply this modifier if an assistant surgeon was necessary for the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required for the procedure.
10. 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.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Apply this modifier if a PA, NP, or CNS assisted in the surgery.
These modifiers help provide additional context and specificity to the billing and coding process, ensuring accurate reimbursement and documentation.
The CPT code 41805 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, including the associated payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have different guidelines and fee schedules. Therefore, it is advisable to consult the relevant MAC for your area to obtain precise information regarding the reimbursement of CPT code 41805.
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 41805. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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