CPT code 48140 is for the partial removal of the pancreas, a procedure used to treat various pancreatic conditions.
CPT code 48140 is for the partial removal of the pancreas, a surgical procedure where a portion of the pancreas is excised. This procedure may be performed to treat conditions such as pancreatic tumors, chronic pancreatitis, or other pancreatic diseases. The code specifically indicates that only a part of the pancreas is removed, rather than the entire organ.
For CPT code 48140 (Partial removal of pancreas), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the work required to perform the procedure is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the surgery.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session. This helps indicate that the partial removal of the pancreas was one of several procedures.
3. Modifier 52 - Reduced Services
- Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion. This might be applicable if the full extent of the planned partial removal was not necessary.
4. Modifier 53 - Discontinued Procedure
- This modifier is used when the procedure is 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 useful when the partial removal of the pancreas is performed in conjunction with other procedures that are not typically reported together.
6. Modifier 62 - Two Surgeons
- Use this modifier when two surgeons work together as primary surgeons performing distinct parts of the procedure. This is applicable if the partial removal of the pancreas requires the expertise of two different surgeons.
7. Modifier 66 - Surgical Team
- Apply this modifier when the procedure requires a surgical team due to its complexity. This indicates that multiple surgeons and possibly other healthcare professionals were involved in the surgery.
8. 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.
9. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required to help with the procedure. It indicates that another surgeon assisted the primary surgeon during the partial removal of the pancreas.
10. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier when an assistant surgeon is required for a minimal portion of the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier when an assistant surgeon is necessary, and a qualified resident surgeon is not available.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- This modifier is used when a non-physician provider assists in the surgery.
These modifiers help provide additional context and detail about the procedure, ensuring accurate billing and appropriate reimbursement.
The CPT code 48140, which involves a partial removal of the pancreas, 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 covered by Medicare.
Additionally, it is important to consult with the specific Medicare Administrative Contractor (MAC) for your region, as they are responsible for processing Medicare claims and can provide detailed information on coverage and reimbursement policies for CPT code 48140.
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