CPT code 58740 is used for procedures involving the removal of adhesions affecting the fallopian tubes or ovaries.
CPT code 58740 is used to describe a surgical procedure known as the lysis of adhesions, specifically targeting the fallopian tubes (salpingolysis) or ovaries (ovariolysis). This procedure involves the removal or separation of adhesions, which are bands of scar tissue that can form after surgery, infection, or inflammation. These adhesions can cause organs to stick together, leading to pain or dysfunction. By performing this procedure, a surgeon aims to restore normal function and alleviate symptoms associated with these adhesions.
For CPT code 58740, which involves the lysis of adhesions (salpingolysis, ovariolysis), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. Documentation must support the substantial additional work and the reason for it.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that multiple procedures were carried out.
3. 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. It is used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.
4. 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 of the initial surgery.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure performed during the postoperative period is unrelated to the original procedure.
6. Modifier LT - Left Side: This modifier is used to specify that the procedure was performed on the left side of the body.
7. Modifier RT - Right Side: This modifier is used to specify that the procedure was performed on the right side of the body.
These modifiers help provide additional information about the procedure performed and ensure accurate billing and reimbursement. It is important to use them appropriately and provide supporting documentation when necessary.
CPT code 58740 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 and their respective reimbursement rates. However, the actual reimbursement for CPT code 58740 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 apply them to local circumstances, which can influence the reimbursement process for this specific CPT code. Healthcare providers should consult their local MAC for detailed information on coverage and reimbursement rates for CPT code 58740.
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