CPT CODES

CPT Code 44625

CPT code 44625 is a medical billing code used to describe the procedure for repairing a bowel opening.

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What is CPT Code 44625

CPT code 44625 is used to describe the surgical procedure for repairing a bowel opening, specifically addressing issues such as a stoma or an abnormal connection between the bowel and the skin. This code indicates that the procedure involves reconstructing or closing the bowel opening to restore normal function and prevent complications.

Does CPT 44625 Need a Modifier?

For CPT code 44625 (Repair bowel opening), the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.

2. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.

3. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.

4. 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.

5. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.

6. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a procedure.

7. Modifier 66 - Surgical Team: Used when a team of surgeons is required to perform the procedure.

8. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs a procedure or service again on the same day.

9. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician on the same day.

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: Used when a related procedure is performed during the postoperative period of the initial procedure.

11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.

12. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.

13. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.

14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required and a qualified resident surgeon is not available.

15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in surgery.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 44625 Medicare Reimbursement

The CPT code 44625 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, including the associated payment rates.

Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and fee schedules. Therefore, it is advisable to consult the relevant MAC for precise information regarding the reimbursement of CPT code 44625 in your specific area.

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