CPT code 96934 is for cellular and subcellular imaging of the skin, used in dermatology to diagnose and monitor skin conditions.
CPT code 96934 is used for the procedure involving cellular and subcellular imaging of the skin. This code is typically utilized when advanced imaging techniques are employed to examine the skin at a microscopic level, allowing healthcare providers to diagnose and monitor various skin conditions with high precision. This can include identifying cellular abnormalities, assessing skin diseases, and guiding treatment plans based on detailed visual data.
For CPT code 96934, 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 a significant, separately identifiable E/M service is performed by the same physician on the same day as the procedure.
2. Modifier 26: Professional component. This modifier is used when only the professional component of the service is being billed, typically when the interpretation of the results is performed separately from the technical component.
3. Modifier 50: Bilateral procedure. This modifier is used when the procedure is performed on both sides of the body during the same session.
4. Modifier 51: Multiple procedures. This modifier is used when multiple procedures are performed during the same session by the same provider.
5. Modifier 52: Reduced services. This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
6. 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.
7. Modifier 76: Repeat procedure or service by the same physician or other qualified health care professional. This modifier is used when a procedure or service is repeated by the same provider on the same day.
8. Modifier 77: Repeat procedure by another physician or other qualified health care professional. This modifier is used when a procedure or service is repeated by a different provider on the same day.
9. 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 returns to the operating room for a related procedure during the postoperative period.
10. 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 provider during the postoperative period of the initial procedure.
11. 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 test results.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 96934 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates. Additionally, it is crucial to consult the local Medicare Administrative Contractor (MAC) for any region-specific guidelines or restrictions that may apply to the reimbursement of CPT code 96934. Each MAC may have unique policies that could impact the reimbursement process, so checking with the appropriate MAC ensures compliance and accurate billing.
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