CPT code 75898 is used for follow-up angiography, which involves imaging to assess blood vessels after a procedure or treatment.
CPT code 75898 is used to describe a follow-up angiography procedure. This code is specifically for imaging studies that are performed after an initial angiographic procedure to assess the status of blood vessels. The follow-up angiography is typically conducted to evaluate the effectiveness of a treatment, such as a stent placement or angioplasty, or to monitor the progression of a vascular condition. It involves the use of contrast material and imaging technology to visualize the blood vessels and ensure that they are functioning properly or to detect any complications that may have arisen since the initial procedure.
When considering the use of modifiers for CPT codes related to X-rays transcath therapy and follow-up angiography, it's essential to understand the context in which these procedures are performed. Modifiers are used to provide additional information about the performed procedure and can affect reimbursement. Below is a list of potential modifiers that could be applicable:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It is applicable if the physician is only interpreting the X-ray or angiography results, and not providing the technical component.
2. Modifier TC - Technical Component: This is used when only the technical component of the service is being billed. It applies if the facility is billing for the use of equipment and supplies, but not the physician's interpretation.
3. 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. It may be necessary if multiple procedures are performed and need to be billed separately.
4. Modifier 76 - Repeat Procedure by Same Physician: This is used when a procedure is repeated by the same physician on the same day. It may apply if follow-up angiography is performed more than once.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure is repeated by a different physician on the same day. It could be relevant if another physician performs a follow-up angiography.
6. 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 a follow-up angiography is required due to complications or related issues from the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This is applicable if the follow-up angiography is unrelated to the initial procedure and occurs during the postoperative period.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although primarily used for lab tests, this modifier can sometimes be relevant if a diagnostic test is repeated for clinical reasons.
Each modifier serves a specific purpose and should be used in accordance with the specific circumstances of the procedure and payer requirements. Proper use of modifiers ensures accurate billing and reimbursement.
The CPT code 75898 is indeed reimbursed by Medicare, but the reimbursement specifics can vary based on several factors.
The Medicare Physician Fee Schedule (MPFS) provides a standardized payment structure for services covered under Medicare Part B, including CPT code 75898. However, the actual reimbursement amount can differ depending on the geographical location and the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in your area.
Each MAC has the authority to interpret national Medicare policies and set local coverage determinations, which can influence the reimbursement rates and requirements for CPT code 75898. Therefore, it is crucial for healthcare providers to consult with their local MAC to understand the precise reimbursement details and any documentation requirements associated with this code.
Discover the power of MD Clarity's RevFind software, designed to meticulously analyze your contracts and pinpoint underpayments with precision. With the ability to detect discrepancies down to the CPT code level, including CPT code 75898, and by individual payer, RevFind ensures you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can enhance your revenue cycle management and optimize your financial outcomes.
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
