CPT code 92979 is used for endoluminal intravascular ultrasound with optical coherence tomography for each additional vessel.
CPT code 92979 is used to describe an endoluminal intravascular ultrasound (IVUS) procedure performed on each additional vessel. This code is typically used in the context of cardiovascular procedures where IVUS technology is employed to provide detailed images of the inside of blood vessels. The procedure helps in assessing the vessel's condition, guiding interventions, and evaluating the success of treatments such as angioplasty or stent placement. The "each additional vessel" aspect of the code indicates that it is used for vessels beyond the first one imaged during the same session, with the primary procedure being reported with a different CPT code.
For CPT code 92979, which pertains to endoluminal procedures, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 26 - Professional Component: This modifier is used when the professional component of the service is being billed separately from the technical component. It indicates that the billing is for the physician's interpretation of the procedure.
2. Modifier TC - Technical Component: This modifier is used when the technical component of the service is being billed separately from the professional component. It indicates that the billing is for the use of equipment and facilities.
3. 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 used to prevent bundling of services that are typically considered inclusive.
4. 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.
5. 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. It indicates that the procedure was necessary to be performed again by another provider.
6. 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 patient requires a return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure or service is performed by the same physician during the postoperative period of another procedure, but is unrelated to the original procedure.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although not typically used for procedures like 92979, this modifier is included for completeness as it indicates a repeat test or procedure to obtain subsequent results.
These modifiers should be used appropriately based on the specific clinical scenario and documentation to ensure accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements.
CPT code 92979 is reimbursed by Medicare, but its reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services and procedures that are covered by Medicare, along with their respective reimbursement rates. However, the actual reimbursement for CPT code 92979 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret Medicare coverage policies and set payment rates within their jurisdiction, which means that providers should verify the specific reimbursement details with their local MAC to ensure compliance and accurate billing.
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