CPT code 61684 is for a surgical procedure on a simple arteriovenous malformation located in the infratentorial region of the brain.
CPT code 61684 is used to describe a surgical procedure for treating an intracranial arteriovenous malformation (AVM) located in the infratentorial region of the brain, which includes areas such as the cerebellum and brainstem. This code specifically refers to a "simple" procedure, indicating that the AVM is less complex in nature, possibly due to its size, location, or the intricacy of the vascular connections involved. This code is utilized by healthcare providers to accurately document and bill for this specific type of neurosurgical intervention.
For CPT code 61684, the following modifiers may be applicable depending on the specific circumstances of the procedure and the billing requirements:
1. Modifier 22 (Increased Procedural Services): Used 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 51 (Multiple Procedures): Applied when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
3. Modifier 52 (Reduced Services): Used when a service or procedure is partially reduced or eliminated at the physician's discretion. Documentation should support the reduction in service.
4. Modifier 59 (Distinct Procedural Service): Indicates that a procedure or service was distinct or independent from other services performed on the same day. This modifier is used to identify procedures that are not typically reported together but are appropriate under the circumstances.
5. Modifier 62 (Two Surgeons): Used when two surgeons work together as primary surgeons performing distinct parts of a procedure. Each surgeon should report their distinct operative work.
6. Modifier 66 (Surgical Team): Applied when a team of surgeons is required to perform a complex procedure. Documentation should support the necessity of a team approach.
7. Modifier 76 (Repeat Procedure by Same Physician): Used when the same procedure is repeated by the same physician subsequent to the original procedure.
8. Modifier 77 (Repeat Procedure by Another Physician): Indicates that a procedure was repeated by another physician after the original procedure.
9. 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 patient requires a return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Applied when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
These modifiers should be used in accordance with payer guidelines and supported by appropriate documentation to ensure accurate billing and reimbursement.
The CPT code 61684 is reimbursed by Medicare, but its reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service. However, the actual reimbursement for CPT code 61684 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for interpreting national policies and setting local coverage determinations, which can influence whether and how much Medicare reimburses for this specific procedure. Healthcare providers should consult their local MAC for detailed information on coverage and reimbursement rates for CPT code 61684.
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