CPT code 91100 is used to describe the procedure of passing an intestinal bleeding tube for diagnostic or therapeutic purposes.
CPT code 91100 is used to describe the procedure of passing an intestinal bleeding tube. This code indicates a specific medical intervention aimed at diagnosing or managing gastrointestinal bleeding by inserting a tube into the intestine to help identify the source of the bleeding and facilitate treatment.
For CPT code 91100, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or unexpected findings during the procedure.
2. 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 procedure, not the technical component.
3. Modifier 52 - Reduced Services
- Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion. This could occur if the full procedure was not necessary or could not be completed.
4. Modifier 53 - Discontinued Procedure
- Use this modifier if the procedure was 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 is often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
6. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same procedure was repeated by the same physician or other qualified healthcare professional subsequent to the original procedure.
7. Modifier 77 - Repeat Procedure by Another Physician
- This modifier is used when the same procedure is repeated by a different physician or other qualified healthcare professional.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- Use this modifier if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial procedure.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon
- Apply this modifier if an assistant surgeon was necessary for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier if a minimum assistant surgeon was required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- This modifier is used when an assistant surgeon is necessary, and a qualified resident surgeon is not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Apply this modifier when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
CPT code 91100 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS) and is eligible for payment. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. Healthcare providers should consult their local MAC for specific coverage guidelines and documentation requirements related to CPT 91100.
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