CPT code 48552 is used for the preparation of a donor pancreas and its associated venous structures for transplantation.
CPT code 48552 is used to describe the preparation of a donor pancreas for transplantation, specifically focusing on the venous aspects of the procedure. This code indicates that the healthcare provider is performing surgical techniques to prepare the pancreas, ensuring that the venous structures are adequately handled for successful transplantation into a recipient.
For CPT code 48552, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the procedure.
2. Modifier 52 - Reduced Services: This modifier indicates that a service or procedure is partially reduced or eliminated at the physician's discretion. It is used when the full service described by the CPT code is not performed.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
4. Modifier 76 - Repeat Procedure or Service by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used when a related procedure is performed during the postoperative period of the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
8. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required during the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required during the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
11. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 48552, which involves the preparation of a donor pancreas for venous drainage, 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 services covered under Medicare Part B. Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 48552.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 48552, and by individual payer. Don't leave money on the table—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
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
