CPT CODES

CPT Code 47122

CPT code 47122 is for the extensive removal of liver tissue during surgical procedures, detailing the specific service provided.

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What is CPT Code 47122

CPT code 47122 is used to describe the procedure of extensive removal of liver tissue, which may involve resection of a significant portion of the liver due to conditions such as tumors or other liver diseases. This code indicates that the surgical intervention is more complex than a standard liver resection, often requiring careful planning and execution to ensure the remaining liver can function adequately post-surgery.

Does CPT 47122 Need a Modifier?

For CPT code 47122, which pertains to the extensive removal of the liver, 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. This could be due to factors such as increased complexity or time.

2. Modifier 51 (Multiple Procedures): Applied when multiple procedures are performed during the same surgical session. This modifier indicates that the extensive liver removal was one of several procedures.

3. Modifier 59 (Distinct Procedural Service): Used to indicate that the procedure is distinct or independent from other services performed on the same day. This could be necessary if the liver removal is performed in conjunction with other unrelated procedures.

4. Modifier 62 (Two Surgeons): Applied when two surgeons work together as primary surgeons performing distinct parts of the procedure. This modifier is used to indicate the collaborative effort required for the extensive liver removal.

5. Modifier 66 (Surgical Team): Used when a team of surgeons is required to perform the procedure due to its complexity. This modifier indicates that the extensive liver removal necessitated a coordinated effort by multiple surgeons.

6. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): Applied if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial liver removal.

7. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required to help with the procedure. This modifier indicates that the extensive liver removal required additional surgical assistance.

8. Modifier 81 (Minimum Assistant Surgeon): Applied when a minimum assistant surgeon is required for the procedure. This indicates that the extensive liver removal needed some level of assistance, but not to the extent of a full assistant surgeon.

9. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is necessary because a qualified resident surgeon is not available. This modifier indicates the need for additional surgical support during the extensive liver removal.

10. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): Applied when a non-physician practitioner assists in the surgery. This indicates that the extensive liver removal required the assistance of a physician assistant, nurse practitioner, or clinical nurse specialist.

These modifiers help provide additional context and detail about the specific circumstances under which the extensive liver removal procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 47122 Medicare Reimbursement

The CPT code 47122 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services covered by Medicare, and it is updated annually to reflect changes in policy and practice. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and guidelines that affect payment. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 47122.

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