CPT code 49002 is for the reopening of the abdomen, typically performed to address complications or issues after an initial surgery.
CPT code 49002 is used to describe the procedure of reopening the abdomen. This code is typically applied when a surgeon needs to access the abdominal cavity again after it has been previously closed, often due to complications or the need for further evaluation or treatment.
For CPT code 49002 (Reopening of abdomen), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the procedure.
2. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: Used if an unrelated evaluation and management service is performed by the same physician during the postoperative period of the initial procedure.
3. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service: Applied when a significant, separately identifiable evaluation and management service is provided by the same physician on the same day as the procedure.
4. Modifier 50 - Bilateral Procedure: Used if the procedure is performed bilaterally.
5. Modifier 51 - Multiple Procedures: Applied when multiple procedures are performed during the same surgical session.
6. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure: Applied when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
9. Modifier 76 - Repeat Procedure or Service by Same Physician: Used when a procedure or service is repeated by the same physician subsequent to the original procedure or service.
10. Modifier 77 - Repeat Procedure by Another Physician: Applied when a procedure or service is repeated by another physician subsequent to the original procedure or service.
11. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used when a related procedure is performed during the postoperative period of the initial procedure.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Applied when an unrelated procedure or service is performed by the same physician during the postoperative period.
13. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: Applied when a minimum assistant surgeon is required for the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required because a qualified resident surgeon is not available.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Applied when these non-physician practitioners assist in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 49002, which involves the reopening of the abdomen, 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 specific Medicare Administrative Contractor (MAC) for your region, as they administer Medicare claims and can provide detailed information on coverage and reimbursement policies for CPT code 49002.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 49002 for reopening of the abdomen. Don't let underpayments slip through the cracks—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
