CPT code 44130 is a medical billing code used for bowel to bowel fusion procedures in healthcare settings.
CPT code 44130 is used to describe a surgical procedure known as bowel to bowel fusion. This procedure involves the surgical connection of two segments of the intestine, typically performed to address issues such as bowel obstruction, trauma, or disease. The goal of this surgery is to restore continuity in the gastrointestinal tract, allowing for normal digestion and absorption of nutrients.
Modifiers for CPT Code 44130 (Bowel to bowel fusion):
1. Modifier 22 - Increased Procedural Services
- Use this modifier when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the surgery.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session. This indicates that the procedure is one of several performed on the same day.
3. Modifier 52 - Reduced Services
- Use this modifier when the procedure is partially reduced or eliminated at the physician's discretion. This could be due to patient condition or other intraoperative findings.
4. Modifier 53 - Discontinued Procedure
- This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- Apply this modifier to indicate that the procedure is distinct or independent from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
6. Modifier 62 - Two Surgeons
- Use this modifier when two surgeons work together as primary surgeons performing distinct parts of the procedure. Each surgeon should report their specific part of the surgery.
7. Modifier 66 - Surgical Team
- This modifier is used when a complex procedure requires the skills of several surgeons, often from different specialties, working together as a team.
8. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier when the same physician performs the procedure again on the same day or during the postoperative period.
9. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier when a different physician performs the procedure again on the same day or during the postoperative period.
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
- This modifier is used when the patient requires a 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
- Apply this modifier when the physician performs an unrelated procedure during the postoperative period of the initial procedure.
12. Modifier 80 - Assistant Surgeon
- Use this modifier when an assistant surgeon is required to assist the primary surgeon during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- This modifier is used when an assistant surgeon is required for a minimal portion of the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier when an assistant surgeon is required because a qualified resident surgeon is not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Use this modifier when a non-physician practitioner assists in the surgery.
Each of these modifiers provides specific information about the circumstances under which the procedure was performed, ensuring accurate billing and appropriate reimbursement.
CPT code 44130 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, reimbursement may vary depending on factors such as the specific Medicare Administrative Contractor (MAC) for your region, medical necessity documentation, and any applicable local coverage determinations (LCDs) or national coverage determinations (NCDs).
Discover how MD Clarity's RevFind software can meticulously read your contracts and detect underpayments down to the CPT code level, including specific codes like 44130, and by individual payer. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.
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