CPT code 47543 is for an endoluminal biopsy of the biliary tree, a procedure to collect tissue samples from the bile ducts.
CPT code 47543 is used to describe an endoluminal biopsy of the biliary tree. This procedure involves obtaining a tissue sample from the bile ducts, which are part of the biliary system that helps in the digestion of fats. The biopsy is typically performed to diagnose conditions affecting the biliary tree, such as tumors, strictures, or other abnormalities.
For CPT code 47543 (Endoluminal biopsy of the biliary tree), 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 support staff.
3. Modifier 59 - Distinct Procedural Service: Used to indicate that the procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: Used when the same physician performs the procedure more than once on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Used when a different physician performs the procedure more than once 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 needs to return 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 performed 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.
12. Modifier LT - Left Side: Used to indicate that the procedure was performed on the left side of the body.
13. Modifier RT - Right Side: Used to indicate that the procedure was performed on the right side of the body.
14. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.
15. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
16. Modifier 53 - Discontinued Procedure: Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
17. Modifier 99 - Multiple Modifiers: Used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 47543 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 payment may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. Providers should consult their local MAC for specific coverage guidelines and reimbursement rates for this procedure.
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