CPT code 47765 is used to describe the procedure of fusing liver ducts and bowel during surgical interventions.
CPT code 47765 is used to describe a surgical procedure that involves fusing the liver ducts with the bowel. This procedure is typically performed to create a connection between the biliary system and the intestinal tract, which can help in cases where there are blockages or other issues affecting bile drainage. The goal of this intervention is to restore proper function and alleviate symptoms related to biliary obstruction.
When using CPT code 47765 for fusing liver ducts and bowel, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and the reasons for their use:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or the patient's condition.
2. Modifier 51 - Multiple Procedures
- Apply this modifier if multiple procedures were performed during the same surgical session. This helps indicate that more than one procedure was carried out.
3. Modifier 52 - Reduced Services
- Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion. This might occur if the full procedure was not necessary.
4. Modifier 53 - Discontinued Procedure
- This modifier is used if the 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
- Apply this modifier to indicate that the procedure was distinct or independent from other services performed on the same day. This is used to avoid bundling issues.
6. Modifier 62 - Two Surgeons
- Use this modifier if two surgeons were required to perform the procedure together, each acting as a primary surgeon.
7. Modifier 66 - Surgical Team
- This modifier is applicable if the procedure required a surgical team due to its complexity.
8. Modifier 76 - Repeat Procedure by Same Physician
- Use this modifier if the same physician performed the procedure more than once on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier if a different physician performed the procedure more than once on the same day.
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
- This modifier is used if the patient had to 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
- Use this modifier if an unrelated procedure was performed by the same physician during the postoperative period of the initial procedure.
12. Modifier 80 - Assistant Surgeon
- Apply this modifier if an assistant surgeon was necessary for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier if a minimum assistant surgeon was required for the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- This modifier is used if an assistant surgeon was necessary because a qualified resident surgeon was not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Apply this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assisted in the surgery.
Each of these modifiers provides additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 47765, which involves the fusion of liver ducts and bowel, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for various medical services and procedures. Additionally, it is essential to consult with the local Medicare Administrative Contractor (MAC) to confirm specific coverage details and any regional variations in reimbursement policies. The MAC is responsible for processing Medicare claims and can provide the most accurate and up-to-date information regarding the reimbursement of CPT code 47765.
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