CPT code 47383 is a medical billing code for percutaneous ablative liver cryoablation procedures used to treat liver tumors.
CPT code 47383 is used to describe a percutaneous ablation procedure of the liver using cryoablation techniques. This procedure involves the application of extreme cold to destroy abnormal tissue in the liver, often used for treating tumors or lesions. The term "percutaneous" indicates that the procedure is performed through the skin, allowing for a minimally invasive approach to liver treatment.
For CPT code 47383, which pertains to percutaneous ablation of liver tumors using cryoablation, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. This could be due to factors such as the patient's condition or the complexity of the procedure.
2. Modifier 26 - Professional Component
- This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for their expertise and interpretation, not the technical component.
3. Modifier 52 - Reduced Services
- Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion. This could occur if the full procedure was not necessary or could not be completed.
4. 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. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier 76 - Repeat Procedure by Same Physician
- This modifier is used when the same physician performs the procedure more than once on the same day. It indicates that the repeated procedure was necessary.
6. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier if a different physician performs the same procedure on the same day. It indicates that the repeated procedure was necessary and performed by another provider.
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
- This modifier is used when the patient requires an unplanned 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
- Use this modifier if the procedure is performed during the postoperative period of another procedure but is unrelated to the original procedure.
9. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required for the procedure. It indicates that another surgeon assisted in the procedure.
10. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if an assistant surgeon was required for a minimal portion of the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- This modifier is used when an assistant surgeon is required because a qualified resident surgeon was not available.
12. Modifier 99 - Multiple Modifiers
- Use this modifier when more than four modifiers are necessary to describe the service provided. It indicates that multiple modifiers are being used.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
Determining if CPT code 47383 is reimbursed by Medicare involves consulting the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the Medicare Administrative Contractor (MAC) for your specific region. The MPFS is a comprehensive listing of the maximum fees Medicare will pay for various services, and it is updated annually.
To verify if CPT code 47383 is reimbursed, you would need to check the MPFS database. This can be done through the Centers for Medicare & Medicaid Services (CMS) website or through your local MAC's online resources. Each MAC may have specific coverage policies and guidelines that can affect reimbursement, so it is crucial to review their directives as well.
In summary, to determine if CPT code 47383 is reimbursed by Medicare, you should:
1. Consult the Medicare Physician Fee Schedule (MPFS).
2. Review the guidelines and policies provided by your regional Medicare Administrative Contractor (MAC).
By following these steps, you can ascertain whether CPT code 47383 is eligible for reimbursement under Medicare.
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