CPT CODES

CPT Code 49450

CPT code 49450 is used for the replacement of a gastrostomy tube through a percutaneous approach.

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What is CPT Code 49450

CPT code 49450 is used to describe the procedure of replacing a gastrostomy or jejunostomy tube through a percutaneous approach. This code indicates that a healthcare provider is performing a minimally invasive procedure to insert a new feeding tube into the stomach or small intestine, typically for patients who require long-term nutritional support.

Does CPT 49450 Need a Modifier?

Certainly! Here are the modifiers that could be used with the CPT code 49450:

1. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service 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 or Service by Same Physician or Other Qualified Health Care Professional
- Used to indicate that a procedure or service was 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 or Other Qualified Health Care Professional
- Indicates that a procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service.

7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional 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.

8. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Indicates that the performance of a procedure or service during the postoperative period was unrelated to the original procedure.

9. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required for the procedure.

10. Modifier 81 - Minimum Assistant Surgeon
- Indicates that a minimum assistant surgeon was required for the procedure.

11. 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.

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 provided 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 49450 Medicare Reimbursement

CPT code 49450 is reimbursed 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 coverage guidelines and documentation requirements related to CPT 49450.

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