CPT code 93567 is used for a procedure involving catheter placement in the heart for aortography, which helps visualize the aorta's structure.
CPT code 93567 is used to describe a procedure involving a catheter-based evaluation of the heart, specifically focusing on the supervision and interpretation of aortography. Aortography is an imaging technique used to visualize the aorta, the main artery carrying blood from the heart to the rest of the body. This code is typically used when a healthcare provider performs a diagnostic study to assess the structure and function of the aorta, often in conjunction with other cardiac catheterization procedures. The code indicates that the provider is responsible for overseeing the procedure and interpreting the results to aid in diagnosing or managing cardiovascular conditions.
For CPT code 93567, which involves a procedure related to cardiac catheterization and aortography, the following modifiers may be applicable:
1. 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 procedure, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the equipment, supplies, and technical support required for the procedure, excluding the professional interpretation.
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 may be necessary if multiple procedures are performed and need to be reported separately.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider on the same day.
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 if the patient needs to 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 is performed during the postoperative period of another procedure, but the two are unrelated.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.
CPT code 93567 is reimbursed by Medicare, but its reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services and their corresponding reimbursement rates, which are updated annually. However, the actual reimbursement for CPT code 93567 can vary based on several factors, including geographic location and local coverage determinations.
Medicare Administrative Contractors (MACs) play a crucial role in determining the reimbursement for CPT code 93567. MACs are responsible for processing Medicare claims and have the authority to establish local coverage policies that may affect the reimbursement of specific CPT codes. Therefore, healthcare providers should consult their respective MACs to understand any local policies or additional documentation requirements that might impact the reimbursement of CPT code 93567.
In summary, while CPT code 93567 is generally reimbursed by Medicare, providers must ensure compliance with both the MPFS guidelines and any specific directives from their MAC to secure appropriate reimbursement.
Discover the power of MD Clarity's RevFind software, designed to meticulously analyze your contracts and pinpoint underpayments with precision. With the ability to detect discrepancies down to the CPT code level, such as 93567, and by individual payer, RevFind ensures you capture every dollar owed. Schedule a demo today to see how RevFind can enhance your revenue cycle management and optimize your financial outcomes.
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
