CPT CODES

CPT Code 48102

CPT code 48102 is a code used to identify a needle biopsy of the pancreas for billing and documentation in healthcare.

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What is CPT Code 48102

CPT code 48102 is used to describe a needle biopsy of the pancreas. This procedure involves using a thin, hollow needle to extract tissue samples from the pancreas for diagnostic purposes. It is typically performed to evaluate pancreatic conditions, such as tumors or inflammation, and helps healthcare providers determine the appropriate course of treatment based on the biopsy results.

Does CPT 48102 Need a Modifier?

For CPT code 48102 (Needle biopsy pancreas), the following modifiers may be applicable:

1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, such as the interpretation of the biopsy results by a physician.

2. Modifier TC - Technical Component: Used when only the technical component of the service is being billed, such as the use of the equipment and the technician's time.

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 repeats the procedure on the same day.

5. Modifier 77 - Repeat Procedure by Another Physician: Used when a different physician repeats the procedure on the same day.

6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure: Used when the patient requires an unplanned 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 and is performed by the same physician during the postoperative period.

8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Used when the same laboratory test is repeated on the same day to obtain subsequent (multiple) test results.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 48102 Medicare Reimbursement

CPT code 48102 is generally reimbursed by Medicare. The reimbursement rate for this procedure can be found in the Medicare Physician Fee Schedule (MPFS). However, coverage and payment policies may vary slightly depending on the specific Medicare Administrative Contractor (MAC) for your region. It's important to verify with your local MAC for any specific guidelines or documentation requirements related to this CPT code.

Are You Being Underpaid for 48102 CPT Code?

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. For instance, ensure you're accurately reimbursed for procedures like CPT code 48102. Schedule a demo today to see how RevFind can optimize your revenue cycle management.

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