CPT code 43752 is a medical billing code for the placement of a nasal or orogastric tube, used for feeding or medication administration.
CPT code 43752 is for the placement of a nasal or orogastric tube. This procedure involves inserting a tube through the nose or mouth into the stomach to provide nutrition, medication, or to remove gastric contents. It is typically performed in patients who are unable to eat or drink normally due to various medical conditions.
Certainly! Here are the modifiers that could be used with CPT code 43752, along with the reasons for each:
1. Modifier 22 - Increased Procedural Services
- Used when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 26 - Professional Component
- Used when only the professional component of the service is being billed.
3. Modifier 52 - Reduced Services
- Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure
- Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician
- Used when the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician
- Used when the same procedure is repeated by another physician.
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
- Used when a related procedure is performed during the postoperative period of the initial procedure.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Used when an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Used when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Used when an assistant surgeon is required because a qualified resident surgeon is not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery
- Used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 43752 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable guidelines, healthcare providers should refer to the MPFS.
Additionally, it is important to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as MACs are responsible for processing Medicare claims and can provide detailed information on coverage and reimbursement policies for CPT code 43752.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 43752. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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