CPT code 93654 is used for comprehensive electrophysiologic evaluation and treatment of ventricular tachycardia, a heart rhythm disorder.
CPT code 93654 is used to describe a comprehensive electrophysiologic evaluation with ablation for treatment of ventricular tachycardia. This procedure involves a detailed study of the heart's electrical system to identify abnormal electrical pathways that are causing the heart to beat irregularly. Once these pathways are identified, the physician uses ablation techniques, often involving radiofrequency energy, to destroy the problematic tissue, thereby restoring normal heart rhythm. This code is typically used by cardiologists or electrophysiologists who specialize in treating complex heart rhythm disorders.
For CPT code 93654, which involves comprehensive electrophysiologic evaluation and treatment of ventricular tachycardia, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and their purposes:
1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, such as the physician's interpretation of the test results.
2. Modifier TC - Technical Component: Applied when only the technical component of the service is being billed, such as the use of equipment and facilities.
3. Modifier 59 - Distinct Procedural Service: Utilized to indicate that a procedure or service was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Applied 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: Used when a related procedure is performed during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Indicates that the procedure is unrelated to the original procedure and is performed during the postoperative period.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for this type of procedure, it may be used if a diagnostic test is repeated for clinical reasons.
These modifiers help clarify the specifics of the service provided and ensure accurate billing and reimbursement. It is important to review the specific circumstances of each case to determine the appropriate modifiers to apply.
CPT code 93654 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the associated payment rates. However, the actual reimbursement for CPT code 93654 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 national Medicare policies and establish local coverage determinations (LCDs) that may affect the reimbursement process. Therefore, healthcare providers should consult their respective MAC for detailed information on the reimbursement criteria and rates applicable to CPT code 93654 in their region.
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