CPT code 63075 is for a cervical discectomy procedure that involves decompressing the spinal cord or nerve roots at a single interspace.
CPT code 63075 is used to describe a surgical procedure known as an anterior cervical discectomy. This procedure involves the removal of a damaged or herniated disc from the cervical spine, which is the neck region. The surgery is performed from the front (anterior) of the neck and includes the decompression of the spinal cord and/or nerve roots. This means that any pressure on these structures is relieved, often by removing bone spurs (osteophytes) that may be contributing to the compression. The procedure is focused on a single interspace, which refers to the space between two vertebrae where the disc is located. This code is essential for healthcare providers to accurately document and bill for the specific surgical intervention performed.
For CPT code 63075, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly greater effort or complexity than typically required.
2. Modifier 50 - Bilateral Procedure: Apply this modifier if the procedure was performed on both sides of the body during the same operative session.
3. Modifier 51 - Multiple Procedures: Use this modifier when multiple procedures are performed during the same surgical session.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day.
5. Modifier 62 - Two Surgeons: Use this modifier if two surgeons were required to perform the procedure due to its complexity.
6. Modifier 76 - Repeat Procedure by Same Physician: Apply this modifier if the same procedure was repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure was repeated by a different 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 if the patient returns to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: Apply this modifier if an assistant surgeon was necessary for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required due to the unavailability of a qualified resident surgeon.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific policies to ensure appropriate use of modifiers.
The CPT code 63075 is reimbursed by Medicare, but the 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 and their corresponding reimbursement rates.
However, the actual reimbursement for CPT code 63075 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 Medicare policies and setting local coverage determinations, which can influence whether and how much a particular service is reimbursed.
Therefore, healthcare providers should consult their specific MAC for detailed information on the reimbursement of CPT code 63075.
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