CPT CODES

CPT Code 49325

CPT code 49325 is a medical billing code for laparoscopic revision of a permanent intraperitoneal catheter.

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What is CPT Code 49325

CPT code 49325 is used to describe a laparoscopic procedure for the revision of a permanent intraperitoneal catheter. This code indicates that the healthcare provider is performing a minimally invasive surgical technique to modify or correct the placement or function of a catheter that has been permanently implanted within the abdominal cavity. This procedure may be necessary due to complications or changes in the patient's condition that require adjustments to the catheter system.

Does CPT 49325 Need a Modifier?

Certainly! Here are the modifiers that could be used with CPT code 49325:

1. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to perform the procedure is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.

2. Modifier 51 (Multiple Procedures): This modifier is used when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.

3. Modifier 52 (Reduced Services): This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion. Documentation should explain why the service was reduced.

4. Modifier 53 (Discontinued Procedure): This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

5. 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 used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.

6. Modifier 62 (Two Surgeons): This modifier is used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.

7. Modifier 66 (Surgical Team): This modifier is used when a team of surgeons (more than two) is required to perform a specific procedure.

8. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used when a procedure or service performed by the same physician is repeated subsequent to the original procedure or service.

9. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when a procedure or service performed by another physician is repeated subsequent to the original procedure or service.

10. 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.

11. 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.

12. Modifier 80 (Assistant Surgeon): This modifier is used when an assistant surgeon is required during the procedure.

13. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when a minimum assistant surgeon is required during the procedure.

14. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is required, and a qualified resident surgeon is not available.

15. 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.

CPT Code 49325 Medicare Reimbursement

Determining if CPT code 49325 is reimbursed by Medicare involves consulting the Medicare Physician Fee Schedule (MPFS) and the guidelines set forth by the Medicare Administrative Contractor (MAC) for your specific region. The MPFS provides a comprehensive list of services and their corresponding reimbursement rates under Medicare Part B.

To verify if CPT code 49325 is reimbursed, you would need to check the MPFS for the current year. This can be done through the Centers for Medicare & Medicaid Services (CMS) website or by using the MPFS lookup tool. Additionally, each MAC may have specific local coverage determinations (LCDs) that could affect reimbursement for this code. Therefore, it is crucial to review any relevant LCDs issued by your regional MAC to ensure compliance and understand any specific documentation or medical necessity requirements.

In summary, to determine if CPT code 49325 is reimbursed by Medicare, consult the MPFS and review any pertinent LCDs from your MAC.

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