CPT code 49326 is a procedure code for laparoscopic surgery with omentopexy, used to describe specific surgical services provided.
CPT code 49326 is used to describe a laparoscopic procedure that involves omentopexy as an add-on service. This means that during a laparoscopic surgery, the surgeon is securing the omentum, a fold of peritoneum extending from the stomach, to another structure in the abdomen. This procedure is typically performed to support or stabilize an organ or tissue, and it is considered an additional service to the primary laparoscopic procedure being conducted.
Certainly! Here is a list of modifiers that could be used with CPT code 49326, along with the reasons for each:
1. Modifier 22 (Increased Procedural Services)
- 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)
- Applied when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
3. 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. This is particularly relevant if the procedures are not typically reported together but are appropriate under the circumstances.
4. Modifier 62 (Two Surgeons)
- Used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure. Each surgeon should report their distinct operative work.
5. Modifier 66 (Surgical Team)
- Applied when a highly complex procedure is carried out by a surgical team. This modifier indicates that the procedure required the skills of several surgeons.
6. Modifier 76 (Repeat Procedure by Same Physician)
- Used when the same physician performs a procedure or service more than once on the same day. This modifier indicates that the procedure was repeated.
7. Modifier 77 (Repeat Procedure by Another Physician)
- Applied when a procedure or service is repeated by another physician on the same day. This indicates that the procedure was performed again by a different provider.
8. 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 patient requires a return to the operating room for a related procedure during the postoperative period of the initial surgery.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period)
- Applied when a procedure or service performed during the postoperative period is unrelated to the original procedure.
10. Modifier 80 (Assistant Surgeon)
- Used when an assistant surgeon is required for the procedure. This modifier indicates that another surgeon assisted in the operation.
11. Modifier 81 (Minimum Assistant Surgeon)
- Applied when a minimum assistant surgeon is required for the procedure. This indicates that the assistance was minimal but necessary.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available))
- Used when an assistant surgeon is required because a qualified resident surgeon was not available.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery)
- Applied when a non-physician provider assists in the surgery. This modifier indicates that a PA, NP, or CNS provided the assistance.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 49326, which is an add-on code, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare. Additionally, it is important to consult with your local Medicare Administrative Contractor (MAC) as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 49326.
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