CPT code 45110 is for the surgical removal of the rectum, detailing the procedure for accurate billing and documentation in healthcare.
CPT code 45110 is the code used for the surgical procedure involving the removal of the rectum. This procedure may be indicated for various medical conditions, including rectal cancer or severe inflammatory diseases. The code specifically denotes the surgical approach and the anatomical focus of the operation, which is essential for accurate billing and documentation in the healthcare revenue cycle.
For CPT code 45110, 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 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: Used when the procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. 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.
7. Modifier 62 - Two Surgeons: Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
8. Modifier 66 - Surgical Team: Used when a team of surgeons is required to perform the procedure.
9. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs a procedure or service again on the same day.
10. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician on the same day.
11. 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.
12. 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.
13. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.
15. 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.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 45110 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services covered by Medicare, and it is updated annually to reflect changes in policy and practice.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and reimbursement policies for specific CPT codes. Therefore, while CPT code 45110 is generally reimbursed by Medicare, healthcare providers should consult the MPFS and their respective MAC for precise information on coverage and payment rates.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 45110. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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