CPT code 63102 is for a lumbar vertebral corpectomy, a procedure involving partial or complete removal of a vertebral body to relieve spinal cord pressure.
CPT code 63102 is used to describe a surgical procedure known as a vertebral corpectomy, which involves the partial or complete removal of a vertebral body. This procedure is performed using a lateral extracavitary approach, which means accessing the spine from the side, outside the usual body cavities. The primary goal of this surgery is to decompress the spinal cord and/or nerve roots, which may be necessary in cases involving tumors or displaced bone fragments. This specific code applies to procedures conducted on the lumbar region of the spine and is used when the surgery is performed on a single spinal segment.
For CPT code 63102, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to increased complexity or time.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed bilaterally, this modifier should be applied to indicate that the procedure was done on both sides.
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 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.
5. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, this modifier indicates that each surgeon performed a distinct part of the procedure.
6. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is 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 needs to return 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: This modifier is used when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier indicates their involvement.
11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when an assistant surgeon is required for a minimal portion of the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
13. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier indicates that multiple modifiers are being used.
These modifiers help provide additional information about the circumstances of the procedure and ensure accurate billing and reimbursement.
CPT code 63102 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 of the Medicare Administrative Contractor (MAC) for the specific region.
The MPFS provides a comprehensive listing of fees used to reimburse physicians and other healthcare providers on a fee-for-service basis. However, the actual reimbursement may vary based on local coverage determinations (LCDs) and national coverage determinations (NCDs) set forth by the MACs.
These contractors have the authority to interpret Medicare policies and determine the medical necessity of services within their jurisdiction. Therefore, it is essential for healthcare providers to verify the specific coverage details and reimbursement rates for CPT code 63102 with their respective MAC to ensure compliance and accurate billing.
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