CPT code 46610 is a medical billing code used for the procedure of removing a lesion during an anoscopy.
CPT code 46610 is used to describe a procedure in which a healthcare provider performs an anoscopy to remove a lesion from the anal canal or rectum. This procedure involves the insertion of a small, tubular instrument called an anoscope, allowing the provider to visualize and excise abnormal tissue or growths. It is typically performed to address issues such as hemorrhoids, polyps, or other lesions that may cause discomfort or indicate underlying health concerns.
For CPT code 46610 (Anoscopy remove lesion), 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 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 session.
4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: Used when a 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 76 - Repeat Procedure by Same Physician: Used when a procedure or service is repeated by the same physician or other qualified healthcare professional.
8. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician or other qualified healthcare professional.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Used when a related procedure during the postoperative period requires a return to the operating room.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure or service is performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.
13. 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.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these professionals assist in surgery.
Each modifier serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
CPT code 46610 is generally reimbursed by Medicare. The reimbursement rate for this procedure can be found in the Medicare Physician Fee Schedule (MPFS). However, coverage and payment policies may vary slightly depending on the specific Medicare Administrative Contractor (MAC) for your region. It's important for healthcare providers to verify current reimbursement rates and any applicable coverage limitations with their local MAC before performing this procedure for Medicare beneficiaries.
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