CPT code 46917 is a code used to describe laser surgery for anal lesions, helping healthcare providers bill for this specific procedure.
CPT code 46917 is used to describe the procedure of laser surgery for anal lesions. This code specifically refers to the treatment of abnormal growths or lesions in the anal area using laser technology, which allows for precise removal or destruction of the tissue while minimizing damage to surrounding areas. This procedure is typically performed to address conditions such as anal warts or other benign lesions, providing a less invasive option compared to traditional surgical methods.
For CPT code 46917 (Laser surgery anal lesions), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly greater effort than typically required.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be appended.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier should be used.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the physician's discretion, this modifier is appropriate.
5. 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.
6. 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.
7. Modifier 76 - Repeat Procedure by Same Physician: If the same physician performs the procedure again on the same day, this modifier should be used.
8. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the procedure on the same day, this modifier is applicable.
9. 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 when the patient needs to return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
11. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier should be appended.
12. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required.
13. 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.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: This modifier is used when these non-physician practitioners assist in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
Determining if CPT code 46917 is reimbursed by Medicare involves checking the Medicare Physician Fee Schedule (MPFS) and consulting with your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, including the associated reimbursement rates. Each MAC, which administers Medicare claims for specific regions, may have additional guidelines or requirements for reimbursement.
To confirm if CPT code 46917 is reimbursed, you should:
1. Review the MPFS: Access the latest version of the MPFS to see if CPT code 46917 is listed and to understand the reimbursement rate.
2. Consult Your MAC: Contact your regional MAC for any specific coverage policies or additional documentation requirements that may apply to CPT code 46917.
By following these steps, you can determine if CPT code 46917 is eligible for reimbursement under Medicare.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 46917. Schedule a demo today to see how RevFind can identify discrepancies by individual payer and help you maximize your revenue.
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