CPT code 47535 is a medical billing code for the conversion of an external biliary drainage catheter.
CPT code 47535 is used to describe the procedure of converting an existing biliary drainage catheter to a different type of catheter. This typically involves the removal of the current catheter and the placement of a new one, which may be necessary for improved drainage or to address complications. The procedure is performed bilaterally, meaning it involves both sides of the biliary system.
For CPT code 47535, 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 a physician or other qualified healthcare professional.
2. Modifier TC - Technical Component: Used when only the technical component of the service is being billed, typically by a facility or hospital.
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 procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician 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 a related procedure is performed during the postoperative period of the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
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 surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
Determining whether CPT code 47535 is reimbursed by Medicare involves consulting the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by your regional Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of services and their corresponding reimbursement rates under Medicare Part B. To verify if CPT code 47535 is reimbursed, you would need to check its status on the MPFS.
Additionally, MACs, which are private health care insurers that have been awarded a geographic jurisdiction to process Medicare Part A and Part B medical claims, may have specific local coverage determinations (LCDs) that affect reimbursement.
Therefore, it is essential to review both the MPFS and any relevant LCDs from your MAC to confirm if CPT code 47535 is reimbursed by Medicare.
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