CPT CODES

CPT Code 49013

CPT code 49013 is for the placement of a peritoneal pelvic pack to control hemorrhage during surgical procedures.

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What is CPT Code 49013

CPT code 49013 is used to describe the procedure of performing a percutaneous abdominal drainage of a hematoma or abscess. This involves inserting a catheter through the skin into the abdominal cavity to remove fluid or blood that has accumulated due to injury or infection. The procedure is typically guided by imaging techniques to ensure accurate placement and is aimed at alleviating pressure and preventing further complications.

Does CPT 49013 Need a Modifier?

Certainly! Here are the modifiers that could be used with CPT code 49013:

1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to provide a service is substantially greater than typically required. For example, if the hemorrhage control procedure was more complex or took significantly longer than usual.

2. Modifier 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same surgical session. If CPT code 49013 is performed along with other procedures, this modifier should be appended.

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. For instance, if the hemorrhage control was performed in a different anatomical site or through a separate incision.

4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician. If CPT code 49013 needs to be performed again during the same encounter, this modifier should be used.

5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician. If another physician needs to perform CPT code 49013 again, this modifier should be appended.

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 if the patient needs to return to the operating room for a related procedure during the postoperative period.

7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure 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 non-physician provider assists in the surgery.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 49013 Medicare Reimbursement

CPT code 49013 is reimbursable by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, coverage and payment may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. Providers should consult their local MAC for detailed guidance on billing and reimbursement for this code.

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