CPT code 43282 is a medical billing code for laparoscopic repair of a paraesophageal hernia using mesh.
CPT code 43282 is used to describe a laparoscopic procedure for the repair of a paraesophageal hernia, which involves the use of mesh. This surgical technique is minimally invasive and is performed through small incisions in the abdomen. The procedure aims to reposition the stomach and other abdominal contents that have moved into the chest cavity due to the hernia, and the mesh is utilized to reinforce the repair and reduce the risk of recurrence.
For CPT code 43282 (Lap paraesoph her rpr w/mesh), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or other factors that necessitate additional time and effort.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session. This helps indicate that the procedure was one of several performed.
3. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day. This is particularly useful when procedures are not typically reported together but are appropriate under the circumstances.
4. Modifier 62 - Two Surgeons
- This modifier is used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure. Each surgeon should report their distinct operative work.
5. Modifier 66 - Surgical Team
- Apply this modifier when a complex procedure requires the services of a surgical team, indicating that multiple professionals were involved in the surgery.
6. Modifier 76 - Repeat Procedure by Same Physician
- Use this modifier if the same physician needs to repeat the procedure on the same day. This helps clarify that the repeat procedure was necessary.
7. Modifier 77 - Repeat Procedure by Another Physician
- This modifier is used when a different physician repeats the procedure on the same day. It indicates that the repeat procedure was necessary and performed by another provider.
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
- Apply this modifier if the patient needs to return 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
- Use this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required to help with the procedure. It indicates that another surgeon assisted the primary surgeon.
11. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier when a minimum assistant surgeon is required for the procedure. This indicates that the assistance was minimal but necessary.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier when an assistant surgeon is necessary because a qualified resident surgeon was not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
These modifiers help provide additional context and detail about the procedure, ensuring accurate billing and reimbursement.
CPT code 43282 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS) and is eligible for payment. However, coverage and reimbursement 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.
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