CPT code 76979 is used for ultrasound guidance in procedures, ensuring precise targeting and monitoring for enhanced accuracy and patient care.
CPT code 76979 is used for the ultrasound guidance of a dynamic microbubble contrast agent for echocardiography, which is an advanced imaging technique. This procedure involves the use of ultrasound waves to visualize the heart and its structures in real-time, enhanced by a contrast agent made up of microbubbles. These microbubbles improve the clarity and detail of the ultrasound images, allowing healthcare providers to better assess cardiac function and detect any abnormalities. The "ea addl" part of the code indicates that this code is used for each additional study performed beyond the initial one, ensuring that billing accurately reflects the number of studies conducted.
For the CPT codes provided, here is a list of potential modifiers that could be applicable, along with the reasons for their use:
1. Modifier 26 (Professional Component):
- Use this modifier if the service involves both a professional and technical component, and you are billing only for the professional component.
2. Modifier TC (Technical Component):
- This modifier is used when billing for the technical component of a service, separate from the professional component.
3. Modifier 59 (Distinct Procedural Service):
- Apply this modifier when a procedure or service is distinct or independent from other services performed on the same day.
4. Modifier 76 (Repeat Procedure by Same Physician):
- Use this modifier if the same procedure is repeated by the same physician on the same day.
5. Modifier 77 (Repeat Procedure by Another Physician):
- This modifier is applicable when the same procedure is repeated by a different physician on the same day.
6. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test):
- Use this modifier for repeat laboratory tests performed on the same day to obtain subsequent (multiple) test results.
7. Modifier 52 (Reduced Services):
- Apply this modifier if the service provided is partially reduced or eliminated at the physician's discretion.
8. Modifier 53 (Discontinued Procedure):
- This modifier is used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
9. Modifier 22 (Increased Procedural Services):
- Use this modifier when the work required to provide a service is substantially greater than typically required.
10. Modifier 99 (Multiple Modifiers):
- Apply this modifier when two or more modifiers are necessary to describe the service provided.
These modifiers help ensure accurate billing and reimbursement by providing additional information about the circumstances under which a service was provided. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
The CPT code 76979 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and the relevant Medicare Administrative Contractor (MAC) for your region.
The MPFS provides a comprehensive list of services covered by Medicare, including their reimbursement rates, while the MACs are responsible for processing claims and providing guidance on Medicare coverage policies.
Therefore, healthcare providers should consult these resources to ensure accurate billing and reimbursement for CPT code 76979.
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