CPT code 61711 is for a surgical procedure connecting extracranial and intracranial arteries, like the middle cerebral or cortical arteries.
CPT code 61711 is used to describe a surgical procedure known as an anastomosis between arterial vessels located outside the skull (extracranial) and those within the skull (intracranial). This procedure typically involves connecting arteries such as the middle cerebral or cortical arteries. It is often performed to improve blood flow to the brain, especially in cases where there is a risk of stroke or other cerebrovascular conditions. This code is crucial for accurately documenting and billing for this complex and specialized surgical intervention in the healthcare revenue cycle.
For CPT code 61711, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: This modifier is 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 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be used to indicate a bilateral procedure.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.
4. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
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 62 - Two Surgeons: If two surgeons are required to perform the procedure, each surgeon should report the procedure with this modifier.
7. Modifier 66 - Surgical Team: When a complex procedure requires a surgical team, this modifier is used to indicate that a team of surgeons was necessary.
8. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider.
9. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider.
10. 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 patient requires a return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
12. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
13. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
14. 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.
15. Modifier 99 - Multiple Modifiers: This modifier is used when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association (AMA) and payer-specific policies. Proper documentation is crucial to support the use of any modifier.
CPT code 61711 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the policies set by the Medicare Administrative Contractor (MAC) for the specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for services rendered. However, the actual reimbursement for CPT code 61711 can vary based on local coverage determinations (LCDs) and national coverage determinations (NCDs) established by the MACs.
These contractors have the authority to interpret Medicare policy and decide whether a particular service is covered in their jurisdiction. Therefore, healthcare providers should consult the relevant MAC for their area to confirm the specific reimbursement details for CPT code 61711 under Medicare.
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