CPT code 49424 is used to describe the procedure of assessing a cyst through contrast injection for imaging purposes.
CPT code 49424 is used to describe the procedure of assessing a cyst through the injection of contrast material. This code indicates that a healthcare provider is performing a diagnostic imaging procedure to evaluate the characteristics of a cyst, which may involve the use of imaging techniques such as ultrasound or CT scans to visualize the cyst after the contrast agent has been introduced. This assessment helps in determining the nature of the cyst and guiding further management or treatment decisions.
For CPT code 49424, 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 procedure, 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 equipment, supplies, and technical staff, but not the professional interpretation.
3. 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 avoid bundling issues and to show that the procedures are not related.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
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 related procedure is performed 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 an unrelated procedure or service is performed by the same physician during the postoperative period of the initial 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 test results.
Each of these modifiers serves a specific purpose and helps to provide additional information about the service performed, ensuring accurate billing and reimbursement.
CPT code 49424 is reimbursable by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating 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 guidelines and reimbursement rates associated with this code.
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