CPT code 48148 is for the surgical removal of the pancreatic duct, a procedure used to treat certain pancreatic conditions.
CPT code 48148 is for the surgical procedure involving the removal of the pancreatic duct. This procedure is typically performed to address conditions affecting the pancreas, such as chronic pancreatitis or pancreatic tumors, where the duct may be obstructed or diseased. The removal aims to alleviate symptoms and improve the patient's overall health by restoring normal pancreatic function.
For CPT code 48148, which pertains to the removal of the pancreatic duct, 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 complications or other factors that increased the complexity of the surgery.
2. Modifier 51 - Multiple Procedures
- Apply this modifier if multiple procedures were performed during the same surgical session. This indicates that the removal of the pancreatic duct 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 occur if the full removal was not necessary or feasible.
4. Modifier 53 - Discontinued Procedure
- This modifier is used if the procedure was started but discontinued due to extenuating circumstances or those that threatened the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- Apply this modifier to indicate that the removal of the pancreatic duct was a distinct service from other procedures performed on the same day. This helps to clarify that the services were separate and not part of a bundled procedure.
6. Modifier 62 - Two Surgeons
- Use this modifier if two surgeons were required to perform the procedure. This indicates that the complexity of the surgery necessitated the skills of two different specialists.
7. Modifier 66 - Surgical Team
- This modifier is applicable if the procedure required a surgical team due to its complexity. It indicates that multiple healthcare professionals were involved in the surgery.
8. Modifier 76 - Repeat Procedure by Same Physician
- Use this modifier if the same physician performed the removal of the pancreatic duct more than once on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier if a different physician performed the removal of the pancreatic duct on the same day as the initial procedure.
10. Modifier 78 - Unplanned Return to the Operating Room
- 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 the removal of the pancreatic duct was performed during the postoperative period of another, unrelated procedure.
12. Modifier 80 - Assistant Surgeon
- Apply this modifier if an assistant surgeon was necessary for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- This modifier is used if an assistant surgeon was required for a minimal part of the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use 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
- Apply this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assisted in the surgery.
These modifiers help provide additional context and detail about the specific circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 48148 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, including the associated payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and fee schedules. Therefore, it is advisable to consult the relevant MAC for your area to confirm the exact reimbursement rate and any specific guidelines that may apply to CPT code 48148.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 48148. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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