CPT code 49419 is for the insertion of a tunneled intraperitoneal catheter with a port, used for accessing the abdominal cavity.
CPT code 49419 is used to describe the procedure of inserting a tunneled intraperitoneal catheter with a port. This involves placing a catheter into the peritoneal cavity through a small incision, allowing for the administration of medications or fluids directly into the abdominal space. The "tunneled" aspect indicates that the catheter is placed under the skin for a distance before entering the peritoneal cavity, which helps to reduce the risk of infection and allows for easier access over time. The inclusion of a port facilitates the connection for infusions or drainage, making the procedure more efficient for ongoing treatment.
For CPT code 49419 (Insert tun ip cath w/port), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier 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 26 - Professional Component
- This modifier is used when only the professional component of the service is being billed. It indicates that the provider performed only the interpretation of the procedure, not the technical component.
3. Modifier 52 - Reduced Services
- Apply this modifier when a service or procedure is partially reduced or eliminated at the physician's discretion. Documentation should support the reason for the reduction.
4. Modifier 53 - Discontinued Procedure
- Use this modifier when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient. Documentation should clearly indicate the reason for discontinuation.
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 often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
6. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
7. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
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
- This modifier is used when a patient requires a return to the operating room for a related procedure during the postoperative period of the initial procedure.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier when an unrelated procedure or service is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon
- This modifier is used when an assistant surgeon is required during the procedure. Documentation should support the necessity of the assistant surgeon.
11. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier when a minimum assistant surgeon is required during the procedure. Documentation should support the necessity of the minimum assistant surgeon.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier when an assistant surgeon is required, and a qualified resident surgeon is not available. Documentation should support the necessity of the assistant surgeon and the unavailability of a resident surgeon.
13. 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. Documentation should support the necessity of the assistant.
Each modifier serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement. Proper documentation is crucial to support the use of any modifier.
The CPT code 49419, which is for the insertion of a tunneled intraperitoneal catheter with a port, is reimbursed by Medicare. Reimbursement for this procedure is determined by the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services provided to Medicare beneficiaries.
Additionally, the specific reimbursement rates and policies can vary depending on the region, as they are administered by the respective Medicare Administrative Contractor (MAC) for that area.
It is essential for healthcare providers to consult the MPFS and their local MAC to confirm the exact reimbursement details for CPT code 49419.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can read your contracts and detect underpayments down to the CPT code level, including specific codes like 49419. Schedule a demo today to see how RevFind can help you identify and address underpayments by individual payer, maximizing your revenue and streamlining your financial operations.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
