CPT Code 23900

CPT code 23900 is a medical code used to describe the procedure of interthoracoscapular amputation, which involves removing the shoulder blade and surrounding tissues.

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What is CPT Code 23900

CPT code 23900 is used to describe an interthoracoscapular amputation, which is a surgical procedure involving the removal of the arm, shoulder blade (scapula), and part of the chest wall. This extensive surgery is typically performed to treat severe trauma, malignancies, or infections that cannot be managed through less invasive methods.

Does CPT 23900 Need a Modifier?

For CPT code 23900 (Interthoracoscopic amputation), the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly greater effort than typically required.

2. Modifier 50 - Bilateral Procedure: Apply this modifier if the procedure was performed on both sides of the body.

3. Modifier 51 - Multiple Procedures: Use this modifier when multiple procedures are performed during the same surgical session.

4. Modifier 52 - Reduced Services: This modifier is used if the procedure was partially reduced or eliminated at the physician's discretion.

5. Modifier 53 - Discontinued Procedure: Apply this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

6. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day.

7. Modifier 62 - Two Surgeons: This modifier is used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.

8. Modifier 66 - Surgical Team: Apply this modifier when a highly complex procedure is carried out by a surgical team.

9. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same physician repeats the procedure.

10. Modifier 77 - Repeat Procedure by Another Physician: Apply this modifier if a different physician repeats the procedure.

11. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier for unplanned returns to the operating room.

12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Apply this modifier for unrelated procedures during the postoperative period.

13. Modifier 80 - Assistant Surgeon: Use this modifier when an assistant surgeon is required for the procedure.

14. Modifier 81 - Minimum Assistant Surgeon: Apply this modifier when a minimum assistant surgeon is required.

15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier when a qualified resident surgeon is not available.

16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Apply this modifier when these professionals assist in the surgery.

Each modifier serves a specific purpose and should be used accurately to ensure proper billing and reimbursement.

CPT Code 23900 Medicare Reimbursement

The CPT code 23900 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding payment rates. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and fee schedules. Therefore, it is advisable to consult the MPFS and the relevant MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 23900.

Are You Being Underpaid for 23900 CPT Code?

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