CPT code 44310 is used to describe the surgical creation of an ileostomy or jejunostomy, allowing waste to exit the body from the small intestine.
CPT code 44310 is used to describe the surgical procedure for the creation of an ileostomy or jejunostomy. This involves the surgical diversion of the small intestine (either the ileum or jejunum) to the abdominal surface, allowing for the passage of intestinal contents into a stoma. This procedure is typically performed for patients who have conditions affecting the lower gastrointestinal tract, such as inflammatory bowel disease or cancer, and it helps manage waste elimination when the normal route is not viable.
For CPT code 44310 (Ileostomy/jejunostomy), the following modifiers may be applicable:
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 increased the complexity of the surgery.
2. Modifier 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same surgical session. It indicates that the ileostomy/jejunostomy was one of several procedures.
3. Modifier 52 - Reduced Services: Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threatened the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day.
6. Modifier 62 - Two Surgeons: If two surgeons worked together as primary surgeons performing distinct parts of the procedure, this modifier should be used.
7. Modifier 66 - Surgical Team: Use this modifier when the procedure requires the services of a surgical team.
8. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the same physician needs to repeat the procedure on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if a different physician repeats the procedure on the same day.
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 if the patient needs 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 During the Postoperative Period: Apply this modifier if the procedure is unrelated to the original surgery and occurs during the postoperative period.
12. Modifier 80 - Assistant Surgeon: Use this modifier if an assistant surgeon was necessary for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: This modifier is used if an assistant surgeon was required for a minimal portion of the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier if an assistant surgeon was necessary due to the unavailability of a qualified resident surgeon.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when a non-physician practitioner assists in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 44310 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates.
Additionally, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 44310. Each MAC may have unique policies that influence how services are reimbursed in different regions.
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