CPT CODES

CPT Code 47560

CPT code 47560 is a procedure code for laparoscopic surgery involving the bile ducts, specifically cholangiography.

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What is CPT Code 47560

CPT code 47560 is used to describe a laparoscopic procedure that involves the exploration of the bile ducts (cholangio). This code indicates that the procedure is performed using minimally invasive techniques, typically involving small incisions and the use of a camera to guide the surgeon. The primary purpose of this procedure is to diagnose or treat conditions related to the bile ducts, such as obstructions or stones.

Does CPT 47560 Need a Modifier?

For CPT code 47560 (Laparoscopy w/cholangio), 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 51 - Multiple Procedures: Indicates that multiple procedures were performed during the same surgical session.

3. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.

4. Modifier 53 - Discontinued Procedure: Indicates that a procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

5. 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.

6. Modifier 62 - Two Surgeons: Indicates that two surgeons worked together as primary surgeons performing distinct parts of a single reportable procedure.

7. Modifier 66 - Surgical Team: Used when a complex procedure requires the services of several physicians, often of different specialties, working together as a team.

8. Modifier 76 - Repeat Procedure by Same Physician: Indicates that a procedure or service was repeated by the same physician subsequent to the original procedure or service.

9. Modifier 77 - Repeat Procedure by Another Physician: Indicates that a procedure or service was repeated by another physician subsequent to the original procedure or service.

10. 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 requires a return to the operating room for a related procedure during the postoperative period.

11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Indicates that the performance of a procedure or service during the postoperative period was unrelated to the original procedure.

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

13. Modifier 81 - Minimum Assistant Surgeon: Indicates that a minimum assistant surgeon was required during the procedure.

14. 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.

15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Indicates that a non-physician provider assisted 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 47560 Medicare Reimbursement

CPT code 47560 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, reimbursement may vary depending on factors such as geographic location and the specific Medicare Administrative Contractor (MAC) responsible for processing claims in the provider's region. Providers should consult their local MAC for specific coverage and payment guidelines related to CPT 47560.

Are You Being Underpaid for 47560 CPT Code?

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