CPT code 44133 is a medical billing code for a live donor enterectomy, used to describe a specific surgical procedure.
CPT code 44133 is used to describe a surgical procedure known as an enterectomy performed on a living donor. This procedure involves the surgical removal of a portion of the intestine, specifically for the purpose of organ donation. It is typically done to facilitate the transplantation of intestinal tissue to a recipient in need, ensuring that the donor's health is carefully managed throughout the process.
When billing for the CPT code 44133, which pertains to an enterectomy from a live donor, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): This modifier is used 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 52 (Reduced Services): This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion. For example, if the enterectomy was planned but not fully completed, this modifier would be appropriate.
3. 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. If the enterectomy was initiated but could not be completed, this modifier would apply.
4. Modifier 62 (Two Surgeons): This modifier is used when two surgeons work together as primary surgeons performing distinct parts of the procedure. If the enterectomy involves two surgeons, this modifier should be used.
5. Modifier 66 (Surgical Team): This modifier is used when a complex procedure requires the services of several physicians, often of different specialties, working together as a team. If the enterectomy requires a surgical team, this modifier would be appropriate.
6. Modifier 80 (Assistant Surgeon): This modifier is used when an assistant surgeon is required during the procedure. If an assistant surgeon is necessary for the enterectomy, this modifier should be applied.
7. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when an assistant surgeon is required on a minimal basis. If the enterectomy requires minimal assistance, this modifier would be appropriate.
8. Modifier 82 (Assistant Surgeon when Qualified Resident Surgeon not Available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available. If the enterectomy requires an assistant surgeon under these circumstances, this modifier should be used.
9. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): This modifier is used when a non-physician provider assists in the surgery. If a physician assistant, nurse practitioner, or clinical nurse specialist assists in the enterectomy, this modifier should be applied.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 44133 is subject to reimbursement by Medicare, but its eligibility for payment depends on several factors. To determine if CPT code 44133 is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates and coverage policies for various CPT codes.
Additionally, it is essential to consult the specific guidelines and policies of the Medicare Administrative Contractor (MAC) that services your geographic region. MACs are responsible for processing Medicare claims and can provide more localized information regarding the reimbursement status of CPT code 44133. By checking both the MPFS and the relevant MAC guidelines, healthcare providers can ascertain whether CPT code 44133 is reimbursed by Medicare.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 44133. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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