CPT code 58541 is for a laparoscopic procedure to remove the uterus, weighing 250 grams or less, while leaving the cervix intact.
CPT code 58541 is used to describe a laparoscopic surgical procedure known as a supracervical hysterectomy, specifically for a uterus that weighs 250 grams or less. In this procedure, the surgeon removes the upper part of the uterus while leaving the cervix intact, using minimally invasive techniques. This code is important for healthcare providers to accurately document and bill for this specific type of hysterectomy, ensuring proper reimbursement and tracking of surgical outcomes.
For CPT code 58541, which pertains to a laparoscopic supracervical hysterectomy for a uterus weighing 250 grams or less, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or unexpected findings during surgery.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.
3. Modifier 52 - Reduced Services: Apply this modifier if the procedure was partially reduced or eliminated at the discretion of the physician.
4. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. 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.
6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, this modifier indicates that both surgeons are working together as primary surgeons.
7. Modifier 66 - Surgical Team: Use this modifier when a team of surgeons is required to perform the procedure due to its complexity.
8. 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 if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is necessary for the procedure, this modifier indicates their involvement.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if an assistant surgeon is required for a minimal part of the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary, and a qualified resident is not available.
Each modifier serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association (AMA) and payer-specific policies to ensure accurate billing and reimbursement.
The CPT code 58541 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines.
The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered under Medicare Part B, including surgical procedures like those represented by CPT code 58541.
The reimbursement amount can vary based on several factors, including geographic location and the specific Medicare Administrative Contractor (MAC) that processes claims in your area.
Each MAC may have its own local coverage determinations (LCDs) that can affect whether and how a particular service is reimbursed.
Therefore, it is crucial for healthcare providers to verify the specific reimbursement details and any applicable coverage policies with their respective MAC to ensure compliance and accurate billing.
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