CPT code 91122 is a medical billing code used to describe an anal pressure recording procedure for healthcare providers.
CPT code 91122 is used to describe a procedure for measuring anal pressure. This test assesses the function of the anal sphincter and helps in diagnosing conditions related to bowel control and rectal function. It involves the insertion of a specialized device to record the pressure within the anal canal, providing valuable information for healthcare providers in evaluating and managing patients with gastrointestinal issues.
For CPT code 91122 (Anal pressure record), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the service provided is significantly greater than typically required. Documentation must support the substantial additional work and the reason for the additional work.
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 test results, 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. Documentation should support the reason for the reduction in services.
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 76 - Repeat Procedure by Same Physician
- This modifier is used when the same physician performs a repeat procedure on the same day. It indicates that the procedure was necessary to be repeated.
6. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier when a procedure is repeated by a different physician on the same day. It signifies that the repeat procedure was necessary and performed by another provider.
7. 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 when the patient requires a return to the operating room for a related procedure during the postoperative period of the initial procedure.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Use this modifier when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the initial procedure.
9. Modifier 99 - Multiple Modifiers
- This modifier is used when two or more modifiers are necessary to describe the service provided. It indicates that multiple modifiers are applicable to the procedure.
Each of these modifiers serves a specific purpose and should be used in accordance with the documentation and circumstances surrounding the procedure. Proper use of modifiers ensures accurate billing and reimbursement.
CPT code 91122 is reimbursed by Medicare. This 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. It's essential to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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