CPT CODES

CPT Code 49014

CPT code 49014 is for reexploration of a pelvic wound, used to describe a specific surgical procedure in medical billing and documentation.

Table of Contents
What is CPT Code 49014
Does CPT 49014 Need a Modifier?
CPT Code 49014 Medicare Reimbursement
Are You Being Underpaid for 49014 CPT Code?
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What is CPT Code 49014

CPT code 49014 is used to describe the procedure of reexploring a pelvic wound. This code indicates that a healthcare provider has performed a surgical intervention to investigate and address complications or issues within the pelvic area that may have arisen from a previous surgery or injury. The reexploration may involve assessing the wound for infection, bleeding, or other abnormalities, and taking necessary actions to ensure proper healing and recovery.

Does CPT 49014 Need a Modifier?

For CPT code 49014 (Reexploration pelvic wound), 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. This could apply if the reexploration is more complex or extensive than usual.

2. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session. This modifier indicates that the reexploration is one of several procedures performed.

3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: Used if the reexploration is planned or anticipated as part of the original procedure, or if it is more extensive than the original procedure.

4. Modifier 59 - Distinct Procedural Service: Used to indicate that the reexploration is a distinct procedure from other services performed on the same day. This modifier helps to clarify that the reexploration is separate and not part of another procedure.

5. 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 if the reexploration is an unplanned return to the operating room due to complications or other issues related to the initial procedure.

6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used if the reexploration is unrelated to the original procedure and occurs during the postoperative period of the initial surgery.

Each of these modifiers serves a specific purpose and should be used according to the circumstances surrounding the reexploration of the pelvic wound. Proper use of these modifiers ensures accurate billing and reimbursement.

CPT Code 49014 Medicare Reimbursement

CPT code 49014 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) and local coverage determinations. Providers should consult their regional MAC for specific coverage and payment information related to CPT 49014.

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