CPT code 47605 is the code used for the surgical removal of the gallbladder, a common procedure in healthcare settings.
CPT code 47605 is the code used to describe the surgical procedure for the removal of the gallbladder, known as a cholecystectomy. This procedure is typically performed to treat gallstones or other gallbladder-related conditions. The code indicates that the removal is done through an open surgical approach, as opposed to laparoscopic techniques, which have their own specific codes.
For CPT code 47605, which pertains to the removal of the gallbladder, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. This could be due to factors such as increased intensity, time, technical difficulty, or severity of the patient's condition.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session. This indicates that the removal of the gallbladder was one of several procedures done.
3. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the removal of the gallbladder was a distinct procedural service from other services performed on the same day. This is often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 62 - Two Surgeons
- This modifier is used when two surgeons work together as primary surgeons performing distinct parts of the procedure. Each surgeon should report their distinct operative work.
5. Modifier 66 - Surgical Team
- Apply this modifier when a complex procedure requires the services of a surgical team. This indicates that the removal of the gallbladder was part of a team effort.
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
- Use this modifier if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial surgery.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery.
8. Modifier 80 - Assistant Surgeon
- Apply this modifier when an assistant surgeon is required to help with the procedure. This indicates that another surgeon assisted in the removal of the gallbladder.
9. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier when an assistant surgeon is required for a minimal portion of the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Apply this modifier when a non-physician practitioner assists in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the procedure.
Determining if CPT code 47605 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 covered by Medicare, along with the corresponding reimbursement rates.
To verify if CPT code 47605 is reimbursed, you would need to check the MPFS for the current year. Additionally, each MAC may have specific coverage policies or local coverage determinations (LCDs) that could affect reimbursement. Therefore, it is essential to review both the MPFS and any relevant LCDs issued by your MAC to confirm if CPT code 47605 is eligible for reimbursement under Medicare.
Discover how MD Clarity's RevFind software can meticulously read your contracts and detect underpayments down to the CPT code level and by individual payer. Ensure you're receiving accurate reimbursements for procedures like CPT code 47605. Schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
