CPT CODES

CPT Code 47802

CPT code 47802 is a medical billing code used to describe the procedure of fusing the liver duct and intestine.

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What is CPT Code 47802

CPT code 47802 is used to describe a surgical procedure that involves fusing the liver duct to the intestine. This procedure is typically performed to create a direct connection between the liver's bile duct and the intestinal tract, facilitating the drainage of bile and improving digestive function. It is often indicated in cases where there are obstructions or other issues affecting bile flow.

Does CPT 47802 Need a Modifier?

When using CPT code 47802 for the procedure "Fuse liver duct & intestine," the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly greater effort than typically required. Documentation must support the substantial additional work.

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 indicates that the full service described by the CPT code was not performed.

4. Modifier 53 - Discontinued Procedure
- Apply this modifier 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
- Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day. This is particularly important for avoiding bundling issues.

6. Modifier 62 - Two Surgeons
- Apply this modifier if two surgeons worked together as primary surgeons performing distinct parts of the procedure. Each surgeon should report their distinct operative work.

7. Modifier 66 - Surgical Team
- Use this modifier if the procedure required the services of a surgical team due to its complexity.

8. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same physician performed the procedure more than once on the same day.

9. Modifier 77 - Repeat Procedure by Another Physician
- Use 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
- Apply this modifier if the patient required an unplanned 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)
- Apply this modifier 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
- Use this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assisted in the surgery.

Each modifier serves a specific purpose and should be used in accordance with the guidelines to ensure accurate billing and reimbursement. Proper documentation is essential to support the use of these modifiers.

CPT Code 47802 Medicare Reimbursement

The CPT code 47802 is reimbursed by Medicare, but its reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).

The MPFS provides a comprehensive list of services covered by Medicare, including the associated reimbursement rates. Additionally, the reimbursement for CPT code 47802 may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region.

It is essential to consult the MPFS and your regional MAC guidelines to determine the exact reimbursement details and any additional requirements that may apply.

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