CPT code 75964 is for a procedure to repair artery blockage, detailing the specific medical service provided by healthcare professionals.
CPT code 75964 is used to describe a medical procedure that involves the repair of an artery blockage. This code specifically refers to the imaging guidance and supervision required during the procedure to ensure that the artery is properly accessed and treated. The procedure typically involves using imaging technology, such as X-rays or ultrasound, to guide the insertion of instruments into the artery to remove or bypass the blockage, thereby restoring normal blood flow. This code is crucial for billing purposes as it helps healthcare providers accurately document and charge for the resources and expertise involved in performing this complex and critical procedure.
When considering the use of modifiers for the CPT codes related to the repair of arterial blockages, it is essential to ensure accurate billing and reimbursement. Here is a list of potential modifiers that could be applicable:
1. Modifier 51 (Multiple Procedures): This modifier may be used if multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed on the same day.
2. 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 is particularly relevant if the procedures are not typically reported together but are appropriate under the circumstances.
3. Modifier 62 (Two Surgeons): If two surgeons are required to perform the procedure due to its complexity, this modifier indicates that both surgeons are actively involved and each is performing a distinct part of the procedure.
4. Modifier 66 (Surgical Team): This modifier is applicable when a surgical team is necessary to perform the procedure. It indicates that the complexity of the procedure requires multiple professionals.
5. Modifier 76 (Repeat Procedure by Same Physician): If the same procedure needs to be repeated by the same physician on the same day, this modifier is used to indicate the repetition.
6. Modifier 77 (Repeat Procedure by Another Physician): Similar to Modifier 76, but used when the repeat procedure is performed by a different physician.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room): This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician): If an unrelated procedure is performed by the same physician during the postoperative period, this modifier is used to indicate that the procedure is not related to the initial surgery.
9. Modifier 80 (Assistant Surgeon): This modifier is used when an assistant surgeon is required to help with the procedure.
10. Modifier 82 (Assistant Surgeon when Qualified Resident Surgeon Not Available): Similar to Modifier 80, but specifically used when a qualified resident surgeon is not available.
These modifiers help in providing additional information about the circumstances under which the procedure was performed, ensuring proper documentation and reimbursement. Always consult the latest coding guidelines and payer-specific policies to determine the appropriate use of modifiers.
To determine if CPT code 75964 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the Medicare Administrative Contractor (MAC) for your specific region.
The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers on a fee-for-service basis. Each MAC may have specific coverage policies and reimbursement rates for CPT codes, including 75964.
Therefore, reimbursement for CPT code 75964 by Medicare can vary based on regional policies and the specific circumstances of the service provided.
It is advisable to verify with the local MAC to ensure accurate and up-to-date information regarding the reimbursement status of CPT code 75964.
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