CPT code 44346 is for the revision of a colostomy, a surgical procedure to modify or repair an existing colostomy.
CPT code 44346 is used to describe the surgical procedure for the revision of a colostomy. This involves making changes or adjustments to an existing colostomy, which is a surgical opening created in the abdomen to allow for the passage of stool. The revision may be necessary due to complications, changes in the patient's condition, or to improve the function and comfort of the colostomy.
When billing for CPT code 44346 (Revision of colostomy), it is essential to consider the appropriate modifiers to ensure accurate reimbursement and compliance with payer requirements. Below is a list of modifiers that could be used with CPT code 44346, along with the reasons for their use:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. Documentation must support the increased complexity.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session. This helps indicate that more than one procedure was carried out.
3. Modifier 52 - Reduced Services
- Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion. Documentation should explain why the service was reduced.
4. Modifier 53 - Discontinued Procedure
- This modifier is appropriate 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 a procedure or service was distinct or independent from other services 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 when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
7. 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.
8. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Apply this modifier if the same procedure is repeated by the same physician or other qualified healthcare professional.
9. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Use this modifier if the same procedure is repeated by a different 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
- This modifier is used when the patient returns to the operating room for a related procedure during the postoperative period of the initial surgery.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery.
12. Modifier 80 - Assistant Surgeon
- Use this modifier when an assistant surgeon is required for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- This modifier is used when an assistant surgeon provides minimal assistance during the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier when an assistant surgeon is necessary because a qualified resident surgeon is not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Use this modifier when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each modifier serves a specific purpose and should be used accurately to reflect the services provided. Proper documentation is crucial to support the use of these modifiers.
The CPT code 44346 is reimbursed by Medicare, but it is essential to verify the specific reimbursement rates and guidelines through the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the allowable charges for services covered by Medicare.
Additionally, it is crucial to consult with your local Medicare Administrative Contractor (MAC) to ensure compliance with regional policies and any specific documentation requirements that may affect reimbursement for CPT code 44346.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 44346. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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