CPT code 48548 is used to describe the surgical procedure of fusing the pancreas and bowel in healthcare billing and documentation.
CPT code 48548 is used to describe a surgical procedure that involves fusing the pancreas to the bowel. This procedure is typically performed to address complications related to pancreatic conditions, such as chronic pancreatitis or pancreatic necrosis, by creating a direct connection between the pancreas and the intestine. This fusion can help improve drainage and reduce the risk of further complications.
For CPT code 48548, which pertains to the fusion of the pancreas and bowel, 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
- 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
- This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
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.
6. Modifier 66 - Surgical Team
- Use this modifier when a complex procedure requires the services of several physicians, often of different specialties, working together as a team.
7. 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.
8. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier when an assistant surgeon is required for a minimal portion of the procedure.
9. 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.
10. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- This modifier is used when a non-physician practitioner assists in the surgery.
These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring accurate billing and appropriate reimbursement.
CPT code 48548 is reimbursed by Medicare. This procedure is listed on the Medicare Physician Fee Schedule (MPFS) and is eligible for payment. 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 related to this code.
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