CPT code 45400 is a code used to describe a laparoscopic procedure for treating certain gastrointestinal conditions.
CPT code 45400 is for a laparoscopic procedure involving the examination of the abdominal cavity. This code specifically refers to the laparoscopic approach used to diagnose or treat conditions related to the gastrointestinal system, allowing for minimally invasive surgery. The use of this code indicates that the procedure was performed using a laparoscope, which is a thin, lighted tube inserted through small incisions in the abdomen, providing a clear view of the internal organs while minimizing recovery time and complications compared to traditional open surgery.
For CPT code 45400, which pertains to a laparoscopic procedure, 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 51 - Multiple Procedures
- Indicates that multiple procedures were performed during the same 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
- Indicates that a procedure was 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 identify procedures/services that are not normally reported together but are appropriate under the circumstances.
6. Modifier 62 - Two Surgeons
- Indicates that two surgeons worked 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 a complex procedure.
8. Modifier 76 - Repeat Procedure by Same Physician
- Indicates that a procedure or service was repeated by the same physician subsequent to the original procedure.
9. Modifier 77 - Repeat Procedure by Another Physician
- Indicates that a procedure or service was repeated by another physician subsequent to the original procedure.
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 patient requires a return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that a procedure performed during the postoperative period was unrelated to the original procedure.
12. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- Indicates that a minimum assistant surgeon was 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
- Indicates that a non-physician provider assisted in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 45400 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 and their corresponding payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and fee schedules. Therefore, healthcare providers should consult their respective MAC for precise information regarding the reimbursement of CPT code 45400.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 45400. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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