CPT CODES

CPT Code 47534

CPT code 47534 is a medical billing code used for placing a biliary drainage catheter to manage bile flow in patients.

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What is CPT Code 47534

CPT code 47534 is for the placement of a biliary drainage catheter. This procedure involves inserting a catheter into the biliary system to relieve obstruction or facilitate drainage of bile. It is typically performed when there is a blockage in the bile ducts, which can occur due to conditions such as gallstones, tumors, or strictures. The placement of this catheter helps to manage symptoms and prevent complications associated with biliary obstruction.

Does CPT 47534 Need a Modifier?

For CPT code 47534, which pertains to the placement of a biliary drainage catheter, the following modifiers may be applicable:

1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, typically by the physician who interprets the results.

2. Modifier TC - Technical Component: Used when only the technical component of the service is being billed, typically by the facility providing the equipment and technical support.

3. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.

4. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician repeats the procedure on the same day.

5. Modifier 77 - Repeat Procedure by Another Physician: Used when a different physician repeats the procedure on the same day.

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: Used when the patient returns to the operating room for a related procedure during the postoperative period.

7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when the procedure is unrelated to the original procedure and is performed by the same physician during the postoperative period.

8. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.

9. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.

10. 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.

11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: 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.

CPT Code 47534 Medicare Reimbursement

CPT code 47534 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's important to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.

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