CPT code 43763 is for replacing a gastrostomy tube using a revision technique, ensuring proper feeding access for patients.
CPT code 43763 is for the replacement of a gastrostomy tube using a revision of the gastric stoma tract. This procedure involves the removal of an existing gastrostomy tube and the insertion of a new one, while also addressing any necessary modifications to the stoma site to ensure proper placement and function of the new tube.
For CPT code 43763, which pertains to the replacement of a gastrostomy tube, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, typically when the service involves both a professional and technical component.
2. Modifier 52 - Reduced Services: Applied when the service provided is less extensive than described in the CPT code.
3. Modifier 53 - Discontinued Procedure: Used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
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 76 - Repeat Procedure by Same Physician: Used when the same physician performs a procedure or service more than once on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician: Applied when a procedure or service is repeated by another physician on the same day.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Indicates that a related procedure was performed during the postoperative period of the initial procedure.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure or service is performed by the same physician during the postoperative period.
9. Modifier 80 - Assistant Surgeon: Applied when an assistant surgeon is required for the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was necessary because a qualified resident surgeon was not available.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 43763 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 important to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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