CPT code 46930 is a medical billing code used to describe the procedure for destroying internal hemorrhoids.
CPT code 46930 is used to describe the procedure for the destruction of internal hemorrhoids. This typically involves techniques such as coagulation or laser treatment to eliminate the hemorrhoidal tissue, providing relief from symptoms associated with internal hemorrhoids.
For CPT code 46930 (Destroy internal hemorrhoids), 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. Documentation must support the substantial additional work.
2. Modifier 50 - Bilateral Procedure: If the procedure was 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 session, this modifier indicates that multiple services were provided.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the physician's discretion, this modifier should be used.
5. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure was repeated by the same physician, this modifier should be appended.
7. Modifier 77 - Repeat Procedure by Another Physician: If the procedure was repeated by a different physician, this modifier should be used.
8. 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 returns to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier should be appended.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon was required for the procedure, this modifier should be used.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
13. 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.
14. Modifier GC - This service has been performed in part by a resident under the direction of a teaching physician: Use this modifier when a resident has participated in the procedure under the supervision of a teaching physician.
15. Modifier QX - CRNA service with medical direction by a physician: This modifier is used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
16. Modifier QY - Medical direction of one CRNA by an anesthesiologist: Use this modifier when an anesthesiologist provides medical direction for one CRNA.
17. Modifier QK - Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals: This modifier is used when an anesthesiologist directs multiple anesthesia procedures concurrently.
18. Modifier QS - Monitored anesthesia care service: This modifier indicates that monitored anesthesia care was provided.
19. Modifier G8 - Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedures: Use this modifier for monitored anesthesia care in complex or invasive procedures.
20. Modifier G9 - Monitored anesthesia care for patient who has history of severe cardiopulmonary condition: This modifier is used when monitored anesthesia care is provided to a patient with severe cardiopulmonary conditions.
These modifiers help provide additional context and specificity to the billing and coding process, ensuring accurate reimbursement and compliance with payer requirements.
The CPT code 46930 is reimbursed by Medicare, but its reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any potential limitations, healthcare providers should consult the MPFS. Additionally, it is essential to verify with the respective Medicare Administrative Contractor (MAC) for any local coverage determinations (LCDs) or specific billing requirements that may apply to this CPT code.
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