CPT code 44361 is for small bowel endoscopy and biopsy procedures, used to document and bill for these specific medical services.
CPT code 44361 is used to describe a procedure involving small bowel endoscopy with biopsy. This code indicates that a healthcare provider performed an endoscopic examination of the small intestine, specifically allowing for the collection of tissue samples (biopsies) for diagnostic purposes. This procedure is typically utilized to investigate conditions affecting the small bowel, such as inflammatory diseases, tumors, or other abnormalities.
For CPT code 44361, which pertains to small bowel endoscopy/biopsy, 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 increased complexity or unusual circumstances.
2. Modifier 26 - Professional Component
- This modifier is used when only the professional component of the service is being billed, typically by the physician.
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 threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician
- Use this modifier if the same procedure was repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier if the same procedure was repeated by a different physician on the same day.
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
- This modifier is used when a related procedure is performed during the postoperative period of the initial procedure.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier 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
- This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
14. Modifier GC - This Service Has Been Performed in Part by a Resident Under the Direction of a Teaching Physician
- Apply this modifier when a resident has performed part of the service under the supervision of a teaching physician.
15. Modifier QK - Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures Involving Qualified Individuals
- Use this modifier if the procedure involves medical direction of multiple concurrent anesthesia procedures.
16. Modifier QS - Monitored Anesthesia Care Service
- This modifier is used to indicate that monitored anesthesia care was provided.
17. Modifier QX - CRNA Service: With Medical Direction by a Physician
- Apply this modifier when a Certified Registered Nurse Anesthetist (CRNA) provides services under the medical direction of a physician.
18. Modifier QY - Medical Direction of One CRNA by an Anesthesiologist
- Use this modifier if an anesthesiologist is providing medical direction for one CRNA.
19. Modifier QZ - CRNA Service: Without Medical Direction by a Physician
- This modifier is used when a CRNA provides services without the medical direction of a physician.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 44361 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, coverage and payment may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's important to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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