CPT code 43653 is a medical billing code for laparoscopic gastrostomy, a minimally invasive procedure to place a feeding tube in the stomach.
CPT code 43653 is for a laparoscopic gastrostomy procedure. This code specifically refers to the surgical creation of an opening in the stomach using minimally invasive techniques, allowing for the placement of a feeding tube. This procedure is typically performed to provide nutritional support for patients who are unable to eat by mouth due to various medical conditions.
For CPT code 43653 (Laparoscopy gastrostomy), 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 the procedure was one of several performed.
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 service described by the CPT code was not performed.
4. Modifier 53 - Discontinued Procedure
- This modifier is used if the procedure was started but discontinued due to extenuating circumstances or those that threatened the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- Apply this modifier to indicate that the procedure was distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
6. Modifier 62 - Two Surgeons
- Use this modifier if two surgeons worked together as primary surgeons performing distinct parts of the procedure.
7. Modifier 66 - Surgical Team
- This modifier is applicable if the procedure required the services of a surgical team due to its complexity.
8. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same physician performed the procedure more than once on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier if a different physician performed the procedure more than once on the same day.
10. 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 if the patient had to return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure was performed by the same physician during the postoperative period of the initial procedure.
12. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon was necessary for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- This modifier is used if a minimum assistant surgeon was required for the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier if an assistant surgeon was necessary because a qualified resident surgeon was not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Use this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assisted in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 43653 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 important to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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