CPT code 76948 is for ultrasound guidance during the aspiration of ovarian cysts, ensuring precise needle placement for effective fluid removal.
CPT code 76948 is used for the ultrasound guidance of an ova (egg) aspiration procedure. This code specifically refers to the use of ultrasound technology to visually guide the physician during the process of retrieving eggs from the ovaries, which is a critical step in assisted reproductive technologies such as in vitro fertilization (IVF). The ultrasound provides real-time imaging, allowing for precise and safe aspiration of the ova. This code covers the imaging and guidance aspect of the procedure, ensuring that the healthcare provider can accurately locate and aspirate the eggs with minimal risk to the patient.
For the CPT codes 76946 and 76948, the use of modifiers may be necessary to provide additional information about the procedure performed. 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 indicates that the provider is billing for the interpretation of the ultrasound guidance, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the use of the equipment and the technician's services, not the interpretation.
3. Modifier 59 - Distinct Procedural Service: This modifier may be used if the ultrasound guidance is performed as a distinct and separate service from other procedures performed on the same day. It helps to indicate that the procedures are not bundled and should be reimbursed separately.
4. Modifier 76 - Repeat Procedure by Same Physician: If the procedure needs to be repeated on the same day by the same provider, this modifier is used to indicate that the repeat procedure was necessary.
5. Modifier 77 - Repeat Procedure by Another Physician: If the procedure is repeated on the same day by a different provider, this modifier is used to indicate that the repeat procedure was necessary.
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 the procedure needs to be repeated due to complications or other reasons during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if the procedure is unrelated to the original procedure and occurs during the postoperative period.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. It is important to review payer-specific guidelines as they may have unique requirements for modifier usage.
To determine if CPT code 76948 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the respective Medicare Administrative Contractor (MAC) for your 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 code 76948, which can vary based on geographic location and other factors.
Therefore, it is advisable to review the MPFS and contact your local MAC to confirm the reimbursement status and any specific requirements or limitations associated with CPT code 76948.
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