CPT CODES

CPT Code 44010

CPT code 44010 is a medical billing code used for the incision of the small bowel during surgical procedures.

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What is CPT Code 44010

CPT code 44010 is for the surgical procedure involving the incision of the small bowel. This code is used to describe a specific operation where a surgeon makes an incision in the small intestine, typically to address issues such as obstruction, perforation, or other gastrointestinal conditions that require direct intervention.

Does CPT 44010 Need a Modifier?

For CPT code 44010 (Incision of small bowel), 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 53 - Discontinued Procedure: Used when a procedure is terminated due to extenuating circumstances or those that threaten the well-being of the patient.

5. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.

6. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a procedure.

7. Modifier 66 - Surgical Team: Indicates that a surgical team was required to perform the procedure.

8. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs a procedure or service more than once on the same day.

9. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician 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: Indicates an unplanned 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: Used when an unrelated procedure or service is performed by the same physician during the postoperative period.

12. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required for the procedure.

13. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.

14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was required because a qualified resident surgeon was not available.

15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in surgery.

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.

CPT Code 44010 Medicare Reimbursement

The CPT code 44010 is reimbursed by Medicare, but the reimbursement is subject to the guidelines outlined in the Medicare Physician Fee Schedule (MPFS). To determine the specific reimbursement rate and any applicable coverage criteria, healthcare providers should consult the MPFS.

Additionally, it is important to verify with the respective Medicare Administrative Contractor (MAC) for any regional variations or additional requirements that may apply to the reimbursement of CPT code 44010.

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