CPT code 47399 is an unlisted procedure for the liver, used when no specific code exists for a unique liver-related service.
CPT code 47399 is used to describe an unlisted procedure related to the liver. This code is applicable when a specific liver procedure does not have a designated CPT code. It allows healthcare providers to report and bill for unique or experimental liver procedures that may not fit into existing categories, ensuring that they can receive reimbursement for services rendered.
For CPT code 47399 (Unlisted procedure, liver), 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 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.
3. Modifier 53 - Discontinued Procedure: Used when a procedure is terminated due to extenuating circumstances or those that threaten the well-being of the patient.
4. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: Used when a procedure or service is repeated by the same provider.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: Indicates that a procedure or service is repeated by a different 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: Used when a patient returns 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: Indicates that a procedure performed during the postoperative period was unrelated to the original procedure.
9. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Indicates that a minimum assistant surgeon was required.
11. 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.
12. Modifier 99 - Multiple Modifiers: Indicates that multiple modifiers are applicable to the procedure.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
Determining if CPT code 47399, an unlisted procedure for the liver, is reimbursed by Medicare requires a review of the Medicare Physician Fee Schedule (MPFS) and consultation with your Medicare Administrative Contractor (MAC).
Since 47399 is an unlisted procedure code, it does not have a predetermined reimbursement rate in the MPFS. Reimbursement for unlisted codes like 47399 typically depends on the submission of detailed documentation that justifies the medical necessity and complexity of the procedure.
Your MAC will review this documentation and determine the appropriate reimbursement on a case-by-case basis. Therefore, while CPT code 47399 can be reimbursed by Medicare, it requires thorough documentation and approval from your MAC.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 47399. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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