CPT CODES

CPT Code 48550

CPT code 48550 is for donor pancreatectomy, a surgical procedure to remove the pancreas from a living donor for transplantation.

Accelerate your revenue cycle

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

Get a Demo

What is CPT Code 48550

CPT code 48550 is used to describe a surgical procedure known as donor pancreatectomy. This procedure involves the surgical removal of the pancreas from a living donor, typically for the purpose of transplantation into a recipient with severe pancreatic disease, such as diabetes. The code specifically indicates that the surgery is performed on a donor, distinguishing it from procedures performed on recipients.

Does CPT 48550 Need a Modifier?

For CPT code 48550 (Donor pancreatectomy), the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.

2. Modifier 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.

3. Modifier 53 - Discontinued Procedure: Used when a procedure is terminated due to extenuating circumstances or those that threaten the well-being of the patient.

4. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.

5. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure.

6. Modifier 66 - Surgical Team: Used when a highly complex procedure is carried out by a surgical team.

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: Indicates a return to the operating room for a related procedure during the postoperative period.

8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when a procedure performed during the postoperative period is unrelated to the original procedure.

9. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required during the procedure.

10. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon provides minimal assistance during the procedure.

11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was necessary because a qualified resident surgeon was not available.

12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.

CPT Code 48550 Medicare Reimbursement

CPT code 48550 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS) and is eligible for payment. However, it's important to note that reimbursement rates may vary depending on the specific Medicare Administrative Contractor (MAC) for your region and other factors such as geographic location and place of service. Healthcare providers should always verify coverage and reimbursement details with their local MAC to ensure accurate billing and payment for this procedure.

Are You Being Underpaid for 48550 CPT Code?

Discover how MD Clarity's RevFind software can read your contracts and detect underpayments down to the CPT code level and by individual payer. Ensure you're receiving accurate reimbursements for procedures like CPT code 48550. Schedule a demo today to see how RevFind can optimize your revenue cycle management.

Get paid in full by bringing clarity to your revenue cycle

Full Page Background