CPT code 92977 is used for procedures involving the dissolution of a clot in a heart vessel, aiding in restoring normal blood flow.
CPT code 92977 is used to describe a medical procedure known as "Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography." This procedure involves the administration of medication directly into the coronary arteries to dissolve a blood clot that is obstructing blood flow to the heart muscle. The process typically includes the use of imaging techniques, such as angiography, to guide the infusion and ensure the medication is delivered precisely to the site of the clot. This code is crucial for healthcare providers to accurately document and bill for the specialized care involved in treating patients with coronary artery blockages.
For CPT code 92977, which involves the procedure to dissolve a clot in a heart vessel, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the procedure involves both a professional and technical component, and the billing is only for the professional component, such as the physician's interpretation of the procedure.
2. Modifier 59 - Distinct Procedural Service: This modifier is applied when the procedure is distinct or independent from other services performed on the same day. It indicates that the procedure is not typically reported together but is appropriate under the circumstances.
3. 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. It indicates that the procedure was necessary to be performed again.
4. Modifier 77 - Repeat Procedure by Another Physician: This modifier is similar to Modifier 76 but is used when the repeat procedure is performed by a different physician.
5. 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 returns to the operating room for a related procedure during the postoperative period of the initial procedure.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
7. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
8. 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.
9. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although not typically associated with procedural codes, this modifier may be used if a diagnostic test related to the procedure needs to be repeated for clinical reasons.
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 92977 is related to a specific medical procedure. To determine if this code is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by the Medicare Administrative Contractor (MAC) for your specific region. The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers on a fee-for-service basis. Each MAC may have slightly different interpretations or additional requirements for coverage, so it is crucial to verify with the MAC that services your area.
For CPT code 92977, you would need to check the current MPFS to see if it is listed and whether it is assigned a reimbursement rate. Additionally, consulting with your MAC will provide clarity on any local coverage determinations (LCDs) or specific billing instructions that might affect reimbursement. If the code is included in the MPFS and there are no restrictive LCDs, it is likely reimbursed by Medicare, subject to meeting all necessary coverage criteria and documentation requirements.
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