CPT code 44202 is a medical billing code used for laparoscopic enterectomy procedures, helping healthcare providers document and bill for services.
CPT code 44202 is for a laparoscopic enterectomy, which is a surgical procedure involving the removal of a portion of the small intestine using minimally invasive techniques. This code is typically used when the surgery is performed through small incisions with the aid of a camera and specialized instruments, allowing for reduced recovery time and less postoperative pain compared to traditional open surgery.
When billing for CPT code 44202 (Lap enterectomy), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or other factors that made the surgery more complex.
2. Modifier 51 - Multiple Procedures: Apply this modifier if multiple procedures were performed during the same surgical session. This helps indicate that the enterectomy was one of several procedures.
3. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion. This could occur if the full enterectomy was not completed as initially planned.
4. Modifier 53 - Discontinued Procedure: This modifier is used if the procedure was 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 enterectomy was a distinct service from other procedures 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 if two surgeons worked together as primary surgeons performing distinct parts of the procedure.
7. Modifier 66 - Surgical Team: This modifier is applicable if the procedure required a surgical team due to its complexity.
8. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same physician performed the enterectomy more than once on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician: Apply this modifier if a different physician performed the enterectomy more than once on the same day.
10. Modifier 78 - Unplanned Return to the Operating Room: Use this modifier if the patient had to return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is used if the enterectomy was performed during the postoperative period of another, unrelated procedure.
12. Modifier 80 - Assistant Surgeon: Apply this modifier if an assistant surgeon was necessary for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if an assistant surgeon was required for a minimal portion of the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used if an assistant surgeon was necessary because a qualified resident was not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Apply this modifier if a non-physician provider assisted in the surgery.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement.
CPT code 44202 is reimbursed by Medicare. This code is included in the Medicare Physician Fee Schedule (MPFS), which determines the payment rates for covered services. Healthcare providers should consult their local Medicare Administrative Contractor (MAC) for specific coverage guidelines and reimbursement rates, as these may vary by region.
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