CPT code 49406 is for imaging catheterization of fluid in the peritoneal or retroperitoneal space, used in diagnostic procedures.
CPT code 49406 is used to describe the procedure of imaging catheterization for the purpose of administering fluid into the peritoneal or retroperitoneal space. This code indicates that a healthcare provider has performed a minimally invasive procedure to visualize and potentially treat conditions related to fluid accumulation in these areas.
For CPT code 49406, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for the interpretation of the imaging study, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the use of the equipment and the performance of the imaging study, not the interpretation.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure or service was distinct or independent from other services performed on the same day. It is used to prevent bundling of services that are typically considered part of a single procedure.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day. It indicates that the repeat procedure was necessary and distinct from the initial procedure.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day. It indicates that the repeat procedure was necessary and distinct from the initial procedure.
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 when a patient returns to the operating room for a related procedure during the postoperative period of the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure or service performed during the postoperative period is unrelated to the original procedure.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when the same laboratory test is repeated on the same day to obtain subsequent (multiple) test results.
9. Modifier XE - Separate Encounter: This modifier is used to indicate that a service was performed during a separate encounter on the same day.
10. Modifier XS - Separate Structure: This modifier is used to indicate that a service was performed on a separate organ/structure.
11. Modifier XP - Separate Practitioner: This modifier is used to indicate that a service was performed by a different practitioner.
12. Modifier XU - Unusual Non-Overlapping Service: This modifier is used to indicate that a service does not overlap usual components of the main service.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 49406, which involves image-guided catheter placement for fluid collection in the peritoneal or retroperitoneal space, is reimbursed by Medicare. To determine the specific reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they can provide detailed information on coverage policies and any potential local variations in reimbursement.
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