CPT code 76981 is used for ultrasound guidance for biopsy of parenchyma, providing detailed imaging to assist in precise tissue sampling.
CPT code 76981 is used for the ultrasound examination of the parenchyma of an organ. Parenchyma refers to the functional tissue in an organ, as opposed to the connective or supporting tissue. This code is typically applied when an ultrasound is performed to assess the internal structure and function of an organ, such as the liver, kidneys, or thyroid, to identify any abnormalities or diseases. The use of this code indicates that the ultrasound is focused on evaluating the specific characteristics and health of the organ's parenchyma.
76979: This CPT code may require the use of modifiers to provide additional information about the procedure performed. Here is a list of potential modifiers that could be used:
1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, typically by a physician or other healthcare provider.
2. Modifier TC - Technical Component: Used when only the technical component of the service is being billed, typically by a facility or hospital.
3. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician on the same day.
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: Used when a related procedure is performed during the postoperative period.
76981: This CPT code may also require modifiers to clarify the service provided. Here is a list of potential modifiers that could be used:
1. Modifier 26 - Professional Component: Used when billing for the professional component of the service.
2. Modifier TC - Technical Component: Used when billing for the technical component of the service.
3. Modifier 59 - Distinct Procedural Service: Used to indicate that the service was distinct from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: Used when the procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Used when the procedure is repeated by a different physician on the same day.
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: Used for related procedures during the postoperative period.
The CPT code 76981 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).
The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates. However, it's important to note that the actual reimbursement can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC).
Each MAC is responsible for interpreting national policies and setting local coverage determinations, which can influence whether and how a particular CPT code like 76981 is reimbursed in different regions.
Healthcare providers should consult their local MAC for the most accurate and up-to-date information regarding reimbursement for CPT code 76981.
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