CPT code 66184 is for the revision of an aqueous shunt in the eye to manage glaucoma.
CPT code 66184 is used to denote a medical procedure involving the revision of an aqueous shunt. This procedure is typically performed when there is a need to adjust, repair, or replace an existing aqueous shunt that helps in draining fluid from the eye to manage intraocular pressure, commonly in patients with glaucoma. The revision is necessary to ensure the shunt functions properly to maintain the desired pressure levels within the eye.
For CPT code 66184, which pertains to the revision of an aqueous shunt, several modifiers may be applicable depending on the specific circumstances of the surgery and billing considerations. Here is an ordered list of potential modifiers and the reasons for their use:
1. -58 Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if the revision of the aqueous shunt is a planned or anticipated procedure that occurs during the postoperative period of the original shunt placement.
2. -78 Return to the Operating Room for a Related Procedure During the Postoperative Period: Use this modifier if the revision is needed due to complications or other reasons related to the first surgery, and it requires a return to the operating room.
3. -79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If the revision of the aqueous shunt is unrelated to the original procedure and occurs during the postoperative period, this modifier should be applied.
4. -76 Repeat Procedure by Same Physician: This modifier can be used if the same physician performs a repeat of the revision procedure on the aqueous shunt.
5. -77 Repeat Procedure by Another Physician: Use this modifier if a different physician performs the revision procedure on the aqueous shunt.
6. -59 Distinct Procedural Service: This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day.
7. -25 Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service: If an evaluation and management service is performed on the same day as the revision, this modifier should be used to indicate that it is significant and separate from the procedure.
8. -24 Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: If an unrelated evaluation and management service is provided during the postoperative period, this modifier should be used.
9. -51 Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier may be used to indicate the secondary or additional procedures.
10. -54 Surgical Care Only: When only the surgical portion of the care is provided by the operating physician, use this modifier.
11. -55 Postoperative Management Only: This modifier is used when one physician performs the postoperative management and another physician performed the surgical procedure.
12. -62 Two Surgeons: When two surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should use this modifier.
13. -80 Assistant Surgeon: Used when an assistant surgeon is present to help the primary surgeon during the procedure.
14. -AS Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used specifically for non-physician practitioners who assist during the surgery.
Each of these modifiers addresses specific circumstances related to the billing and execution of the procedure, ensuring accurate and appropriate reimbursement for services rendered.
CPT code 66184, which refers to the revision of an aqueous shunt, is generally reimbursed by Medicare. However, the specific amount of reimbursement can vary based on the geographic location and the setting in which the procedure is performed (e.g., hospital outpatient department vs. ambulatory surgical center). To determine the exact reimbursement rate, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the CMS (Centers for Medicare & Medicaid Services) website or through Medicare Administrative Contractors (MACs) that manage claims and payments in specific regions. Additionally, it's important to ensure that all documentation and coding are accurately completed to meet Medicare's requirements for coverage and payment.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to read your contracts and identify discrepancies down to specific CPT codes, such as 66184 for the revision of aqueous shunt, RevFind ensures that each claim is fully compensated according to your payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to for every procedure billed.
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