CPT code 42140 is for the surgical removal of the uvula, a small tissue at the back of the throat, often performed to treat certain medical conditions.
CPT code 42140 is the procedure for the surgical removal of the uvula, which is the small, fleshy extension at the back of the throat. This procedure may be performed to treat conditions such as obstructive sleep apnea or chronic throat irritation. The excision can help alleviate symptoms by reducing airway obstruction or inflammation associated with the uvula.
For CPT code 42140 (Excision of uvula), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly greater effort than typically required.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed bilaterally, this modifier should be appended.
3. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same session, this modifier should be used.
4. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
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 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be used.
7. Modifier 77 - Repeat Procedure by Another Physician: If the same procedure is repeated by a different physician, this modifier should be appended.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier if the patient returns to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required, this modifier should be used.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: This modifier is used when these healthcare professionals assist in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
CPT code 42140 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, coverage and payment may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's essential to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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 42140, and by individual payer. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.
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