CPT code 49435 is for the insertion of a subcutaneous extension to an intraperitoneal catheter, used in specific medical procedures.
CPT code 49435 is used to describe the procedure of inserting a subcutaneous extension to an intraperitoneal catheter. This procedure typically involves placing a tube under the skin to connect to an existing catheter that is already positioned in the peritoneal cavity, allowing for easier access for fluid exchange or medication administration.
For CPT code 49435, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Used when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 52 - Reduced Services
- Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.
3. Modifier 53 - Discontinued Procedure
- Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
4. Modifier 59 - Distinct Procedural Service
- Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician
- Used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 77 - Repeat Procedure by Another Physician
- Indicates that a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
7. 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 related procedure is performed during the postoperative period of the initial procedure.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that an unrelated procedure or service is performed by the same physician during the postoperative period.
9. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during the procedure.
10. Modifier 81 - Minimum Assistant Surgeon
- Indicates that a minimum assistant surgeon is required during the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Used when an assistant surgeon is required and a qualified resident surgeon is not available.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Indicates that a physician assistant, nurse practitioner, or clinical nurse specialist is providing services as an assistant at surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 49435 is reimbursable by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS) and is eligible for payment. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. Healthcare providers should consult their local MAC for specific guidelines and documentation requirements to ensure proper reimbursement for this procedure.
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