CPT code 44394 is a medical billing code for a colonoscopy procedure that includes the use of a snare to remove polyps or tissue.
CPT code 44394 is for a colonoscopy procedure that involves the use of a snare technique. This code specifically indicates that during the colonoscopy, a snare device is utilized to remove polyps or other abnormal tissue from the colon. The snare allows for precise excision, making it an effective method for addressing lesions found during the examination.
For CPT code 44394 (Colonoscopy with snare), 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 unusual anatomy or complications.
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 51 - Multiple Procedures: Apply this modifier when multiple procedures are performed during the same session. It indicates that the procedure is one of several performed.
4. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: This modifier is used when the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. 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.
7. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure is repeated by the same physician on the same day.
8. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day.
9. 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 is used when the patient needs to return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Apply this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
11. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Use this modifier when a minimum assistant surgeon is required.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This is used when an assistant surgeon is required, and a qualified resident surgeon is not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: This modifier is used when these non-physician practitioners assist in the surgery.
15. Modifier LT - Left Side: This modifier is used to indicate that the procedure was performed on the left side of the body.
16. Modifier RT - Right Side: This modifier is used to indicate that the procedure was performed on the right side of the body.
17. Modifier GC - This service has been performed in part by a resident under the direction of a teaching physician: This is used in teaching settings where residents are involved in the procedure.
18. Modifier QX - CRNA service with medical direction by a physician: This is used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
19. Modifier QY - Medical direction of one CRNA by an anesthesiologist: This is used when an anesthesiologist provides medical direction for one CRNA.
20. Modifier QK - Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals: This is used when an anesthesiologist is directing multiple anesthesia procedures concurrently.
21. Modifier QS - Monitored anesthesia care service: This is used to indicate that monitored anesthesia care was provided.
22. Modifier G8 - Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedures: This is used for specific anesthesia services.
23. Modifier G9 - Monitored anesthesia care for patient who has history of severe cardiopulmonary condition: This is used when the patient has a severe cardiopulmonary condition.
24. Modifier PT - Colorectal cancer screening test; converted to diagnostic test or other procedure: This is used when a screening colonoscopy is converted to a diagnostic or therapeutic procedure.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
CPT code 44394 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which determines the payment rates for covered services. However, reimbursement may vary depending on factors such as geographic location and the specific Medicare Administrative Contractor (MAC) processing the claim. Providers should consult their local MAC for specific coverage and payment guidelines related to this CPT code.
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