CPT code 44155 is for the removal of a colon or ileostomy, detailing the specific surgical procedure for accurate billing and documentation.
CPT code 44155 is for the surgical procedure involving the removal of a colon or ileostomy. This code specifically indicates the excision of a segment of the colon or the ileum, which may be necessary due to various medical conditions such as cancer, inflammatory bowel disease, or other gastrointestinal disorders. The procedure typically involves the resection of the affected area and may include the creation of an anastomosis, where the remaining sections of the intestine are reconnected.
For CPT code 44155, 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. This could be due to complications or additional work that is not usually part of the procedure.
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 performed.
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: Applied 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: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is often used to avoid bundling issues.
6. Modifier 62 - Two Surgeons: Applied when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
7. Modifier 66 - Surgical Team: Used when a highly complex procedure requires the services of several physicians, often of different specialties, working together as a team.
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: 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 a procedure or service performed during the postoperative period is unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Applied when an assistant surgeon provides minimal assistance during 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 these non-physician practitioners assist in surgery.
These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
Determining if CPT code 44155 is reimbursed by Medicare involves consulting the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services and procedures covered by Medicare, along with their respective reimbursement rates.
To verify if CPT code 44155 is reimbursed, you would need to check the MPFS for the current year. Additionally, since MACs have jurisdiction over specific regions and can influence coverage decisions, it is essential to review any local coverage determinations (LCDs) or policies issued by your regional MAC. These policies can provide further clarification on whether CPT code 44155 is reimbursed and under what conditions.
In summary, to determine if CPT code 44155 is reimbursed by Medicare, consult the MPFS and review any relevant guidelines or policies from your regional MAC.
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