CPT code 44126 is a medical billing code for an enterectomy procedure performed without tapering the congenital segment.
CPT code 44126 is used to describe an enterectomy procedure performed without tapering of the remaining bowel. This surgical operation involves the removal of a segment of the intestine, specifically the small intestine, and is typically indicated for conditions such as tumors, strictures, or inflammatory diseases. The absence of tapering means that the ends of the intestine are reconnected without narrowing the diameter, which can help maintain normal bowel function post-surgery.
For CPT code 44126, 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. This could be due to complications or additional time and effort.
2. Modifier 51 (Multiple Procedures): Applied when multiple procedures are performed during the same surgical session. This helps in indicating that more than one procedure was carried out.
3. Modifier 59 (Distinct Procedural Service): Used to identify procedures/services that are not normally reported together but are appropriate under the circumstances. This modifier indicates that the procedures are distinct and separate.
4. Modifier 62 (Two Surgeons): When two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure, each surgeon should report their distinct operative work by adding this modifier.
5. Modifier 66 (Surgical Team): Used when a team of surgeons (more than two) is required to perform the procedure due to the complexity of the case.
6. Modifier 76 (Repeat Procedure by Same Physician): Applied when the same physician performs a procedure or service again on the same day.
7. Modifier 77 (Repeat Procedure by Another Physician): Used when a procedure or service is repeated by another physician on the same day.
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): This modifier is used when a patient requires a return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Applied when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required to help with the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Applied 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 necessary, and a qualified resident surgeon is not available.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): Applied when a non-physician practitioner assists in the surgery.
These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 44126 is reimbursed by Medicare. This 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. Providers should consult their local MAC for specific coverage guidelines and reimbursement rates for CPT 44126.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the payments you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 44126, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify and address underpayments by individual payer, enhancing your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
