CPT code 49451 is a medical billing code for the percutaneous replacement of a duodenal or jejunal tube.
CPT code 49451 is used to describe the procedure of replacing a percutaneous duodenal or jejunal tube. This involves the insertion of a new feeding tube into the duodenum or jejunum through the abdominal wall, typically performed when the existing tube is malfunctioning or needs to be replaced for continued nutritional support.
When using CPT code 49451 for the replacement of a duodenal or jejunal tube percutaneously, 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, typically by the physician.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed, typically by the facility.
3. Modifier 52 - Reduced Services: This modifier is used when the service provided is less extensive than described in the CPT code.
4. Modifier 53 - Discontinued Procedure: This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
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.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same physician performs a procedure or service more than once on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician on the same day.
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 related procedure is performed during the postoperative period of the initial procedure.
9. 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.
10. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: This modifier is used when these non-physician practitioners assist in surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 49451, which involves the replacement of a duodenal or jejunal tube percutaneously, is reimbursed by Medicare. To determine the reimbursement specifics, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for various services covered under Medicare Part B. Additionally, it is essential to consult with the respective Medicare Administrative Contractor (MAC) for your region, as they provide localized guidance and may have specific billing requirements or policies that impact reimbursement for CPT code 49451.
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