CPT code 44187 is a medical billing code for laparoscopic ileostomy or jejunostomy procedures, used to describe specific surgical services.
CPT code 44187 is used to describe a laparoscopic procedure for creating an ileostomy or jejunostomy. This involves the surgical formation of an opening from the ileum or jejunum (parts of the small intestine) to the abdominal wall, allowing for the diversion of intestinal contents. The laparoscopic approach indicates that the surgery is performed using minimally invasive techniques, which typically result in less postoperative pain and quicker recovery times compared to traditional open surgery.
For CPT code 44187 (Lap ileo/jejuno-stomy), 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.
2. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same surgical session.
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 terminated 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.
6. Modifier 62 - Two Surgeons: Applied when two surgeons work together as primary surgeons performing distinct parts of a procedure.
7. Modifier 66 - Surgical Team: Used when a highly complex procedure is carried out by a surgical team.
8. Modifier 76 - Repeat Procedure by Same Physician: Applied when a procedure or service is repeated by the same physician or other qualified healthcare professional.
9. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician or other qualified healthcare professional.
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: Applied when a related procedure is performed during the postoperative period of the initial procedure.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period.
12. Modifier 80 - Assistant Surgeon: Applied when an assistant surgeon is required during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Applied when an assistant surgeon is required and a qualified resident surgeon is not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
When determining if CPT code 44187 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by your regional Medicare Administrative Contractor (MAC). The MPFS is a comprehensive listing of the maximum fees Medicare will pay for various services, and it is updated annually.
To verify if CPT code 44187 is reimbursed, you should:
1. Check the MPFS: Access the latest MPFS database or tool available on the Centers for Medicare & Medicaid Services (CMS) website. Enter the specific CPT code 44187 to see if it is listed and to review the associated reimbursement rates.
2. Consult Your MAC: Each MAC may have specific guidelines and coverage determinations that can affect reimbursement. Contact your regional MAC or visit their website to find any local coverage determinations (LCDs) or other relevant information regarding CPT code 44187.
By following these steps, you can determine if CPT code 44187 is reimbursed by Medicare and understand any specific conditions or limitations that may apply.
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