CPT code 75958 is for an X-ray procedure that examines the proximal extension of the thoracic aorta, aiding in diagnostic imaging.
CPT code 75958 is used to describe a radiological procedure that involves the placement of a catheter in the thoracic aorta, which is the section of the aorta located in the chest. This procedure is typically performed to obtain detailed images of the aorta and its branches, helping healthcare providers diagnose or evaluate conditions such as aneurysms, blockages, or other vascular abnormalities. The "prox ext" in the description indicates that the procedure focuses on the proximal (near) and external (outer) parts of the thoracic aorta.
When considering the use of modifiers for CPT codes related to X-ray procedures, it's important to ensure accurate billing and reimbursement. Here 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 indicates that the provider is billing for the interpretation of the X-ray, not the technical component.
2. Modifier TC (Technical Component): This is used when only the technical component of the service is being billed. It signifies that the provider is billing for the equipment, supplies, and technical staff involved in the procedure.
3. Modifier 59 (Distinct Procedural Service): This modifier may be necessary if the X-ray procedure is performed in conjunction with another procedure that is not typically reported together. It indicates that the procedures are distinct and separate.
4. Modifier 76 (Repeat Procedure by Same Physician): If the X-ray procedure needs to be repeated on the same day by the same physician, this modifier is used to indicate that the repeat service was necessary.
5. Modifier 77 (Repeat Procedure by Another Physician): Similar to Modifier 76, but used when the repeat procedure is performed by a different physician.
6. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test): Although primarily used for lab tests, if applicable, this modifier indicates that a repeat test was performed on the same day for a specific reason.
7. Modifier 52 (Reduced Services): This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
8. Modifier 53 (Discontinued Procedure): If the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier is appropriate.
9. 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 clarify the specifics of the service provided and ensure that the billing accurately reflects the work performed. Always consult the latest coding guidelines and payer-specific policies to determine the appropriate use of modifiers.
To determine if CPT code 75958 is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS) and consult with their regional Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of services covered by Medicare, along with the associated reimbursement rates. Each MAC is responsible for processing Medicare claims and can offer specific guidance on coverage and reimbursement policies for CPT code 75958 in their jurisdiction.
It is essential for providers to verify with their MAC to ensure accurate billing and reimbursement for this specific code.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 75958, RevFind offers unparalleled precision in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and secure your financial health.
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
