CPT code 91123 is a medical billing code used for the procedure of irrigating fecal impaction in patients.
CPT code 91123 is used to describe the procedure of irrigating fecal impaction. This code specifically refers to the process of using a fluid solution to help clear a blockage in the intestines caused by hardened stool. The irrigation technique is typically performed to relieve constipation and restore normal bowel function.
For CPT code 91123, which pertains to the irrigation of fecal impaction, 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 unusual circumstances.
2. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
- Apply this modifier if a significant, separately identifiable evaluation and management (E/M) service was performed by the same physician on the same day as the procedure.
3. Modifier 52 - Reduced Services
- This modifier is used when the procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Apply this modifier if the procedure needs to be repeated by the same physician or healthcare professional.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Use this modifier if the procedure is repeated by a different physician or healthcare professional.
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 if the patient needs to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 99 - Multiple Modifiers
- Use this modifier when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines to ensure accurate billing and reimbursement.
The CPT code 91123 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 91123. Additionally, MACs can offer guidance on any regional variations or specific documentation requirements that may affect reimbursement. Always consult the latest MPFS and your MAC to ensure compliance and accurate reimbursement for CPT code 91123.
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