CPT CODES

CPT Code 44100

CPT code 44100 is a medical code used to describe a biopsy procedure of the bowel for billing and documentation purposes.

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What is CPT Code 44100

CPT code 44100 is for a biopsy of the bowel. This procedure involves the removal of a small sample of tissue from the bowel for diagnostic purposes. It is typically performed to investigate abnormalities, such as inflammation or tumors, and to help determine the presence of diseases like cancer or infections. The biopsy can be conducted using various techniques, often during an endoscopic examination, allowing for a more accurate diagnosis and appropriate treatment planning.

Does CPT 44100 Need a Modifier?

For CPT code 44100 (Biopsy of bowel), the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.

2. Modifier 26 - Professional Component: Indicates that the service provided was the professional component only, such as the interpretation of results.

3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same session by the same provider.

4. Modifier 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.

5. Modifier 53 - Discontinued Procedure: Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

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

7. Modifier 76 - Repeat Procedure by Same Physician: Used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.

8. Modifier 77 - Repeat Procedure by Another Physician: Indicates that a procedure or service is repeated by another physician or other qualified healthcare professional 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 patient returns to the operating room for a related procedure during the postoperative period.

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 because a qualified resident surgeon is not available.

14. Modifier 99 - Multiple Modifiers: Indicates that multiple modifiers are applicable to the procedure.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 44100 Medicare Reimbursement

CPT code 44100 is reimbursed by Medicare. The reimbursement rate for this code is determined by the Medicare Physician Fee Schedule (MPFS). Healthcare providers should consult their local Medicare Administrative Contractor (MAC) for specific coverage guidelines and payment rates, as these may vary by region.

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