CPT code 42844 is for extensive surgery of the throat, detailing specific procedures performed to treat various throat conditions.
CPT code 42844 is for extensive surgery of the throat. This code is used to describe surgical procedures that involve significant intervention in the throat area, typically addressing complex conditions that may require extensive tissue removal or reconstruction. It indicates a higher level of complexity and resource utilization compared to more routine throat surgeries.
For CPT code 42844, which pertains to extensive surgery of the throat, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the surgery.
2. Modifier 50 - Bilateral Procedure: If the surgery is performed on both sides of the throat, this modifier should be used to indicate that the procedure was bilateral.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that additional procedures were carried out.
4. Modifier 52 - Reduced Services: This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: If the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier should be applied.
6. 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.
7. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of the procedure, this modifier should be used.
8. Modifier 66 - Surgical Team: This modifier is used when a highly complex procedure requires the services of several physicians, often of different specialties, working together as a team.
9. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure, this modifier should be used.
10. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the procedure, this modifier is applicable.
11. 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 when the patient needs to return to the operating room for a related procedure during the postoperative period.
12. 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 of the initial procedure.
13. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required during the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: This modifier is used when these non-physician practitioners assist in the surgery.
These modifiers help provide additional information about the circumstances under which the surgery was performed, ensuring accurate billing and reimbursement.
CPT code 42844 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, reimbursement may vary depending on factors such as geographic location and the specific Medicare Administrative Contractor (MAC) processing the claim. Providers should consult their local MAC for specific coverage and payment guidelines related to this CPT code.
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