CPT code 45910 is a medical billing code for the dilation of rectal narrowing, used to describe a specific procedure in healthcare.
CPT code 45910 is for the dilation of rectal narrowing. This procedure involves the widening of a constricted area in the rectum to alleviate symptoms such as obstruction or difficulty in bowel movements. It is typically performed using specialized instruments to gently stretch the narrowed section, improving the patient's comfort and functionality.
For CPT code 45910, "Dilation of rectal narrowing," 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 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.
3. Modifier 53 - Discontinued Procedure: Used when a procedure is terminated due to extenuating circumstances or those that threaten the well-being of the patient.
4. Modifier 59 - Distinct Procedural Service: Indicates 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: Used when the same procedure is repeated by the same physician.
6. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician.
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: Indicates a 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: Used when an unrelated procedure is performed by the same physician during the postoperative period.
9. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required for the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was required because a qualified resident surgeon was not available.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 45910 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, Medicare Administrative Contractors (MACs) may have specific guidelines or local coverage determinations (LCDs) that could affect reimbursement. Therefore, it is advisable to consult the MPFS and the relevant MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 45910.
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