CPT code 45345 is a medical billing code for a sigmoidoscopy procedure with stent placement, used to describe specific healthcare services.
CPT code 45345 is a procedure that involves performing a sigmoidoscopy, which is an examination of the sigmoid colon and rectum using a flexible tube with a light and camera. During this procedure, a stent is placed to help keep the colon open or to relieve a blockage. This code specifically indicates that the sigmoidoscopy was performed with the additional step of stent placement, highlighting the complexity and purpose of the intervention.
For CPT code 45345 (Sigmoidoscopy with stent), 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 complications or other factors that increased the complexity of the procedure.
2. Modifier 52 - Reduced Services: Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
3. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
4. 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.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure was repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician: Apply this modifier if the same procedure was repeated by a different physician on the same day.
7. 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 modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure or service is performed by the same physician during the postoperative period.
9. Modifier 80 - Assistant Surgeon: Apply this modifier if an assistant surgeon was necessary for the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Apply this modifier if a non-physician practitioner assisted in the surgery.
13. Modifier LT - Left Side: Use this modifier if the procedure was performed on the left side of the body.
14. Modifier RT - Right Side: Apply this modifier if the procedure was performed on the right side of the body.
15. Modifier 99 - Multiple Modifiers: Use this modifier if more than four modifiers are necessary to describe the service.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement.
CPT code 45345 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) and local coverage determinations. Providers should consult their regional MAC for specific coverage and payment information related to CPT 45345.
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