CPT code 43652 is a medical billing code for laparoscopic surgery on the vagus nerve, used to describe specific procedures for healthcare providers.
CPT code 43652 is used to describe a laparoscopic procedure involving the vagus nerve. This minimally invasive surgery typically aims to treat conditions such as obesity by altering the function of the vagus nerve, which plays a significant role in regulating appetite and digestion. The procedure involves the use of small incisions and specialized instruments to access and manipulate the vagus nerve, promoting a reduction in food intake and aiding in weight management.
For CPT code 43652 (Laparoscopy, surgical; with placement of a device to facilitate gastric decompression and/or enteral feeding), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 51 - Multiple Procedures: Indicates that multiple procedures were performed during the same surgical session.
3. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure.
6. Modifier 66 - Surgical Team: Used when a team of surgeons is required to perform the procedure.
7. Modifier 76 - Repeat Procedure or Service by Same Physician: Indicates that a procedure or service was repeated by the same physician subsequent to the original procedure or service.
8. Modifier 77 - Repeat Procedure by Another Physician: Indicates that a procedure or service was repeated by another physician subsequent to the original procedure or service.
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: Used when a related procedure is performed during the postoperative period of the initial procedure.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Indicates that the performance of a procedure or service during the postoperative period was unrelated to the original procedure.
11. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Indicates that a minimum assistant surgeon was required during the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required and a qualified resident surgeon is not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Indicates that a non-physician provider assisted in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 43652 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. To determine the exact reimbursement rate and any additional requirements, healthcare providers should consult the MPFS.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing Medicare claims and providing guidance on coverage policies. Providers should check with their respective MAC to confirm any local coverage determinations (LCDs) or national coverage determinations (NCDs) that may affect the reimbursement of CPT code 43652. This ensures compliance with Medicare's billing and coding guidelines, ultimately facilitating accurate and timely reimbursement.
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