CPT code 70498 is used for a CT angiography of the neck, a diagnostic imaging procedure to visualize blood vessels and assess vascular conditions.
CPT code 70498 is used to describe a computed tomography (CT) angiography of the neck. This procedure involves using CT imaging technology to visualize the blood vessels in the neck, including arteries and veins. It is typically performed to assess vascular conditions, such as blockages, aneurysms, or other abnormalities in the neck's blood vessels. The procedure provides detailed images that help healthcare providers diagnose and plan treatment for various vascular issues in the neck region.
When dealing with CPT codes 70496 and 70498, it is important to consider the appropriate use of modifiers to ensure accurate billing and reimbursement. Here is a list of potential modifiers that could be applied to these codes, along with the reasons for their use:
1. Modifier 26 (Professional Component):
- Used when only the professional component of the service is being billed. This is applicable if the physician is providing the interpretation of the CT angiography but not the technical component.
2. Modifier TC (Technical Component):
- Applied when only the technical component of the service is being billed. This is relevant if the facility is billing for the use of equipment and supplies but not the physician's interpretation.
3. Modifier 59 (Distinct Procedural Service):
- Utilized to indicate that a procedure or service was distinct or independent from other services performed on the same day. This can be necessary if multiple imaging services are provided and need to be distinguished from one another.
4. Modifier 76 (Repeat Procedure by Same Physician):
- Used when the same procedure is repeated by the same physician on the same day. This modifier helps clarify that the repeat service was necessary.
5. Modifier 77 (Repeat Procedure by Another Physician):
- Applied when the same procedure is repeated by a different physician on the same day. This ensures that the repeat service is appropriately documented and billed.
6. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test):
- Although primarily used for laboratory tests, this modifier can sometimes be relevant if the imaging is repeated for clinical reasons, separate from the initial test.
7. Modifier 52 (Reduced Services):
- Used when a service or procedure is partially reduced or eliminated at the physician's discretion. This might be applicable if the full scope of the CT angiography was not completed.
8. Modifier 53 (Discontinued Procedure):
- Applied when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient. This modifier indicates that the procedure was started but not completed.
These modifiers help clarify the nature of the services provided and ensure that billing accurately reflects the work performed. Proper use of modifiers can prevent claim denials and ensure appropriate reimbursement.
The CPT code 70498 is indeed reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS).
The reimbursement rates and coverage specifics for CPT code 70498 can vary based on geographic location and other factors, which are determined by the respective Medicare Administrative Contractor (MAC) for each region.
It is essential for healthcare providers to verify the specific reimbursement details with their local MAC to ensure accurate billing and compliance with Medicare guidelines.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level, including CPT code 70498, and by individual payer. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
