CPT code 76082 is an add-on for computer-aided detection with mammograms, enhancing image analysis to assist radiologists in identifying abnormalities.
CPT code 76082 is an add-on code used in medical billing to indicate the use of computer-aided detection (CAD) during a mammogram. This code is specifically used when CAD is employed as an additional tool to analyze mammographic images for signs of breast cancer. It is important to note that this code is used in conjunction with the primary mammography procedure code, as it represents an additional service provided to enhance the accuracy of the mammogram interpretation.
1. Modifier 26 - Professional Component
- This modifier is used when only the professional component of the service is being billed. It is applicable when the healthcare provider is responsible for the interpretation of the results but not the technical aspect of the procedure.
2. Modifier TC - Technical Component
- This modifier is used when only the technical component of the service is being billed. It applies when the provider is responsible for the equipment, supplies, and technical staff involved in the procedure, but not the interpretation of the results.
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 is applicable when procedures are not typically reported together but are appropriate under the circumstances.
4. Modifier 76 - Repeat Procedure by Same Physician
- This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
5. Modifier 77 - Repeat Procedure by Another Physician
- This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test
- This modifier is used for repeat laboratory tests performed on the same day to obtain subsequent (multiple) test results.
These modifiers are essential for accurate billing and reimbursement, ensuring that the nuances of each service provided are clearly communicated to payers. Proper use of modifiers can prevent claim denials and optimize revenue cycle management for healthcare providers.
CPT code 76082 is subject to reimbursement considerations under Medicare, but whether it is reimbursed can depend on several factors, including the Medicare Physician Fee Schedule (MPFS) and the policies of the specific Medicare Administrative Contractor (MAC) in your region.
The MPFS outlines the payment rates for services covered by Medicare, and each MAC has the authority to interpret and implement Medicare policies, which can affect the reimbursement status of specific CPT codes like 76082.
Therefore, it is crucial for healthcare providers to verify the reimbursement status of CPT code 76082 with their local MAC and review the latest updates in the MPFS to ensure compliance and proper billing practices.
Discover the power of precision with MD Clarity's RevFind software. Our advanced solution meticulously analyzes your contracts to detect underpayments, pinpointing discrepancies down to the CPT code level, including CPT code 76082, and by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and ensure you're receiving the full reimbursement you deserve.
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