CPT CODES

CPT Code 43651

CPT code 43651 is a medical billing code for laparoscopic surgery on the vagus nerve, used to describe specific healthcare procedures.

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What is CPT Code 43651

CPT code 43651 is for a laparoscopic procedure involving the vagus nerve. This code specifically refers to the surgical technique used to access and manipulate the vagus nerve through small incisions in the abdomen, utilizing a camera and specialized instruments. This procedure is often performed for therapeutic purposes, such as treating obesity or certain gastrointestinal disorders, by altering the function of the vagus nerve to help regulate appetite and digestion.

Does CPT 43651 Need a Modifier?

For CPT code 43651, which pertains to laparoscopy involving the vagus nerve, 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 increased the complexity of the surgery.

2. Modifier 51 - Multiple Procedures: Apply this modifier if multiple procedures were performed during the same surgical session. This helps in indicating that more than one procedure was carried out.

3. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion. This indicates that the full scope of the procedure was not completed.

4. 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. It helps in identifying procedures that are not typically reported together but are appropriate under the circumstances.

5. Modifier 62 - Two Surgeons: Apply this modifier if two surgeons were required to perform the procedure together due to its complexity. Each surgeon should report their distinct operative work.

6. Modifier 66 - Surgical Team: Use this modifier if the procedure required a surgical team due to its complexity. This indicates that multiple professionals were involved in the surgery.

7. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the same physician needs to repeat the procedure on the same day. It helps in identifying that the procedure was necessary to be performed again.

8. Modifier 77 - Repeat Procedure by Another Physician: Apply this modifier if a different physician needs to repeat the procedure on the same day. This indicates that the procedure was necessary to be performed again by another provider.

9. 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 needs to return to the operating room for a related procedure during the postoperative period.

10. 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 of the initial procedure.

11. Modifier 80 - Assistant Surgeon: Apply this modifier if an assistant surgeon was necessary for the procedure. This indicates that another surgeon assisted in the operation.

12. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required for the procedure. This indicates that the assistance was minimal but necessary.

13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used if an assistant surgeon was necessary because a qualified resident surgeon was not available.

14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Apply this modifier if a non-physician practitioner assisted in the surgery.

These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 43651 Medicare Reimbursement

CPT code 43651 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.

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