CPT code 91022 is a medical billing code used for a duodenal motility study, which assesses the movement in the duodenum.
CPT code 91022 is a procedure that involves a duodenal motility study, which is used to assess the movement and function of the duodenum, the first part of the small intestine. This study typically measures the pressure and contractions within the duodenum to evaluate gastrointestinal motility disorders. It helps healthcare providers diagnose conditions related to abnormal digestive function, such as gastroparesis or intestinal obstruction.
For CPT code 91022, Duodenal motility study, the following modifiers may 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 study, 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 equipment, supplies, and technical staff involved in the study, not the interpretation.
3. Modifier 52 - Reduced Services: This modifier is used when the service provided is less extensive than described in the CPT code. It indicates that the procedure was partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure: This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. 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 helps to avoid bundling issues and ensures that each service is recognized separately.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same physician performs a repeat procedure or service on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician on the same day.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when the same laboratory test is performed multiple times on the same day for the same patient, typically to obtain subsequent (multiple) test results.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services provided.
The CPT code 91022, which pertains to a duodenal motility study, is reimbursed by Medicare under specific conditions. To determine if this particular CPT code is covered, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the reimbursement rates and coverage criteria for various CPT codes. Additionally, it is essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as MACs are responsible for processing Medicare claims and can provide specific guidance on coverage policies and any local coverage determinations (LCDs) that may apply to CPT code 91022.
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