CPT code 44401 is a medical billing code for a colonoscopy procedure that includes ablation to treat certain conditions.
CPT code 44401 is a procedure that involves performing a colonoscopy, which is an examination of the colon using a flexible tube with a camera. During this procedure, ablation is also conducted, meaning that abnormal tissue within the colon is destroyed or removed using various techniques, such as heat or cold. This code specifically indicates that both the diagnostic aspect of the colonoscopy and the therapeutic action of ablation are being performed in a single session.
For CPT code 44401 (Colonoscopy with ablation), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 26 - Professional Component: Indicates that only the professional component of the service was provided.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same session.
4. Modifier 52 - Reduced Services: Indicates that a service was partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: Used when a 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: Indicates 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: Used when a procedure or service is repeated by the same physician or other qualified healthcare professional.
8. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician or other qualified healthcare professional.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Indicates an unplanned return to the operating/procedure room by the same physician following the initial procedure for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician: Used when an unrelated procedure or service is performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required for the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon was required for the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was required because a qualified resident surgeon was not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.
15. Modifier GC - This Service Has Been Performed in Part by a Resident Under the Direction of a Teaching Physician: Indicates that a resident performed part of the service under the supervision of a teaching physician.
16. Modifier QX - CRNA Service with Medical Direction by a Physician: Used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
17. Modifier QY - Medical Direction of One CRNA by an Anesthesiologist: Indicates that an anesthesiologist is directing one CRNA.
18. Modifier QZ - CRNA Service without Medical Direction by a Physician: Used when a CRNA provides anesthesia services without the medical direction of a physician.
These modifiers help provide additional information about the circumstances under which the colonoscopy with ablation was performed, ensuring accurate billing and reimbursement.
CPT code 44401 is reimbursed by Medicare. The 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 essential to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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