CPT code 48145 is for the partial removal of the pancreas, a surgical procedure to treat various pancreatic conditions.
CPT code 48145 is for the partial removal of the pancreas, a surgical procedure that involves excising a portion of the pancreatic tissue. 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 being removed, rather than the entire organ.
For CPT code 48145, which pertains to the partial removal of the pancreas, 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, severity of the patient's condition, or physical and mental effort required.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session. This indicates that more than one procedure was carried out, and it helps in the correct allocation of reimbursement.
3. Modifier 52 - Reduced Services
- This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion. It indicates that the service provided was less than what is typically required for the procedure.
4. Modifier 53 - Discontinued Procedure
- Use this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient. This helps in documenting that the procedure was not completed as planned.
5. Modifier 62 - Two Surgeons
- Apply this modifier when two surgeons work together as primary surgeons performing distinct parts of the procedure. This indicates that both surgeons are equally responsible for the procedure and should be reimbursed accordingly.
6. Modifier 66 - Surgical Team
- This modifier is used when a highly complex procedure requires the services of several physicians, often of different specialties, working together as a team. It indicates the collaborative effort needed for the procedure.
7. 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. This indicates that the return was unplanned and related to the initial surgery.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier when an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery. This helps in distinguishing the unrelated nature of the subsequent procedure.
These modifiers help in providing additional context and specificity to the billing and coding process, ensuring accurate documentation and appropriate reimbursement for the services rendered.
CPT code 48145 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's essential to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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