CPT code 96900 is for ultraviolet light therapy, a treatment used for various skin conditions by exposing the skin to UV light.
CPT code 96900 is used to describe ultraviolet light therapy. This type of therapy involves exposing the skin to ultraviolet light to treat various skin conditions, such as psoriasis, eczema, and vitiligo. The code is used by healthcare providers to document and bill for this specific treatment when it is administered to patients.
For CPT code 96900 (Ultraviolet light therapy), the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. This modifier is used when an E/M service is provided on the same day as the ultraviolet light therapy and is distinct from the therapy itself.
2. Modifier 59: Distinct procedural service. This modifier is used to indicate that the ultraviolet light therapy is a distinct service from other procedures performed on the same day.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified health care professional. This modifier is used when the ultraviolet light therapy is repeated on the same day by the same provider.
4. Modifier 77: Repeat procedure by another physician or other qualified health care professional. This modifier is used when the ultraviolet light therapy is repeated on the same day by a different provider.
5. Modifier 91: Repeat clinical diagnostic laboratory test. This modifier is used when the same laboratory test is performed multiple times on the same day to obtain subsequent results.
6. Modifier 52: Reduced services. This modifier is used when the ultraviolet light therapy is partially reduced or eliminated at the physician's discretion.
7. Modifier 53: Discontinued procedure. This modifier is used when the ultraviolet light therapy is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 22: Increased procedural services. This modifier is used when the ultraviolet light therapy requires significantly more work than typically required.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 96900 for ultraviolet light therapy is reimbursed by Medicare, but it is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). Reimbursement can vary based on the local coverage determinations (LCDs) set by the Medicare Administrative Contractor (MAC) for your region. It is essential to consult the MPFS and your regional MAC to understand the specific criteria and documentation requirements necessary for Medicare reimbursement of CPT code 96900.
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