CPT code 44605 is a medical billing code used to describe the repair of a bowel lesion in healthcare services.
CPT code 44605 is used to describe the surgical procedure for the repair of a bowel lesion. This code indicates that a healthcare provider has performed a surgical intervention to correct or mend a specific abnormality or damage within the bowel, which may involve techniques such as suturing or resection to restore normal function and integrity of the intestinal tract.
For CPT code 44605 (Repair of bowel lesion), 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. This could be due to factors such as the complexity of the patient's condition or the extent of the lesion.
2. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same surgical session. This indicates that the repair of the bowel lesion was one of several procedures performed.
3. Modifier 59 - Distinct Procedural Service: Used to indicate that the procedure is distinct or independent from other services performed on the same day. This is particularly relevant if the repair of the bowel lesion is performed in conjunction with other procedures that are not typically performed together.
4. Modifier 62 - Two Surgeons: Applied when two surgeons work together as primary surgeons performing distinct parts of the procedure. This modifier indicates that the repair of the bowel lesion required the expertise of two surgeons.
5. Modifier 66 - Surgical Team: Used when a team of surgeons is required to perform the procedure due to its complexity. This modifier indicates that the repair of the bowel lesion was performed by a surgical team.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Applied if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial surgery.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when the repair of the bowel lesion is performed during the postoperative period of another, unrelated procedure.
8. Modifier 80 - Assistant Surgeon: Applied when an assistant surgeon is required to help with the procedure. This indicates that the repair of the bowel lesion required additional surgical assistance.
9. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure. This indicates that the repair of the bowel lesion required minimal but necessary assistance.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Applied when an assistant surgeon is necessary because a qualified resident surgeon is not available.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when a non-physician practitioner assists in the surgery. This indicates that the repair of the bowel lesion involved assistance from a PA, NP, or CNS.
These modifiers help provide additional context and detail about the circumstances under which the repair of the bowel lesion was performed, ensuring accurate billing and reimbursement.
The CPT code 44605 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates. Additionally, the reimbursement for CPT code 44605 may vary depending on the local policies and guidelines set forth by the Medicare Administrative Contractor (MAC) for the region in which the service is provided. It is essential for healthcare providers to verify the specific reimbursement details with their respective MAC to ensure compliance and accurate billing.
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