CPT code 92944 is used for reporting additional procedures related to chronic cardiac revascularization, aiding in precise medical service documentation.
CPT code 92944 is used to describe an additional percutaneous coronary intervention (PCI) procedure performed on a chronic total occlusion (CTO) in a coronary artery. This code is specifically for when a healthcare provider performs a revascularization procedure to restore blood flow in a completely blocked coronary artery that has been occluded for an extended period. The term "additional" indicates that this procedure is performed in conjunction with another primary PCI procedure. This code is crucial for accurate billing and documentation, ensuring that healthcare providers are reimbursed for the complex and resource-intensive nature of treating chronic total occlusions.
For CPT code 92944, which pertains to a specific cardiovascular procedure, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component only, such as the interpretation of the procedure.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be used to indicate a bilateral procedure.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same session, this modifier is used to indicate that more than one procedure was performed.
4. 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.
5. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, this modifier indicates that each surgeon performed a distinct part of the procedure.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day.
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: This modifier is used when a related procedure is performed during the postoperative period.
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.
10. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 92944, which is associated with a specific medical procedure, is subject to reimbursement by Medicare, but this depends on several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that determines whether a particular CPT code is reimbursable and at what rate. The MPFS outlines the payment rates for services provided to Medicare beneficiaries, and CPT code 92944 would be listed there if it is covered.
Additionally, Medicare Administrative Contractors (MACs) play a significant role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to make local coverage determinations (LCDs) that can affect whether a specific service is reimbursed in their jurisdiction. Therefore, while CPT code 92944 may be reimbursed under the MPFS, healthcare providers should also consult their local MAC to confirm coverage specifics and any additional requirements that may apply.
Discover the power of MD Clarity's RevFind software to ensure you're capturing every dollar owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 92944, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and enhance your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
