CPT code 93590 is a procedure code used to describe a percutaneous transcatheter closure of a mitral valve, aiding in accurate medical service documentation.
CPT code 93590 is used to describe a percutaneous transcatheter closure of a mitral valve. This procedure involves the use of a catheter to access the heart through the blood vessels, allowing for the closure of a defect or opening in the mitral valve without the need for open-heart surgery. It is a minimally invasive technique often employed to address issues such as mitral valve regurgitation, where the valve does not close properly, allowing blood to flow backward into the heart. This code is essential for healthcare providers to accurately document and bill for this specific cardiac intervention.
For CPT code 93590, which involves a percutaneous transcatheter closure of a mitral valve, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component, such as the interpretation of the procedure, rather than the technical component.
2. Modifier 52 - Reduced Services: If the procedure is partially reduced or eliminated at the physician's discretion, this modifier indicates that the service was less than usually required.
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 part of a comprehensive procedure.
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.
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.
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 related procedure is performed during the postoperative period of the initial procedure.
7. 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 of the initial procedure.
8. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
9. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
These modifiers are used to provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. It is important to select the appropriate modifier to reflect the specific situation accurately.
CPT code 93590 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) for the region in which the service is provided.
The MPFS outlines the payment rates for services covered by Medicare, and each MAC may have additional local coverage determinations that affect reimbursement.
Therefore, healthcare providers should verify the status of CPT code 93590 with their respective MAC to ensure compliance and confirm reimbursement eligibility.
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