CPT code 58825 is used for the procedure involving the repositioning of one or both ovaries to a different location within the body.
CPT code 58825 is a medical billing code used to describe the surgical procedure of transposing one or both ovaries. This procedure involves repositioning the ovaries to a different location within the pelvic cavity. It is often performed to protect the ovaries from potential damage during treatments such as radiation therapy, which could affect fertility or ovarian function. By using this code, healthcare providers can accurately document and bill for the specific surgical service provided, ensuring proper reimbursement and record-keeping within the healthcare revenue cycle.
For CPT code 58825, which involves the transposition of ovary(s), the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both ovaries. It indicates that the procedure was conducted bilaterally, which may affect reimbursement.
2. Modifier 51 - Multiple Procedures: If the transposition of the ovary(s) is performed in conjunction with other procedures during the same surgical session, this modifier is used to denote multiple procedures.
3. Modifier 59 - Distinct Procedural Service: This modifier is applied when the procedure is distinct or independent from other services performed on the same day. It is used to indicate that the transposition of the ovary(s) is separate from other procedures.
4. Modifier 22 - Increased Procedural Services: If the procedure required significantly more work than typically required, this modifier can be used to indicate the increased complexity or time involved.
5. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier is used to indicate the collaborative effort.
6. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is necessary to complete the procedure.
7. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Similar to Modifier 80, but specifically used when a qualified resident surgeon is not available to assist.
These modifiers help provide additional information about the circumstances under which the procedure was performed, which can be crucial for accurate billing and reimbursement. Always ensure that the use of modifiers is supported by proper documentation in the patient's medical record.
CPT code 58825 is subject to reimbursement considerations under Medicare, but whether it is reimbursed depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set by the Medicare Administrative Contractor (MAC) for the region.
The MPFS provides a list of services and procedures that Medicare reimburses, along with the associated payment rates. Each MAC, which administers Medicare claims for a specific geographic area, may have additional local coverage determinations (LCDs) that influence whether a particular CPT code is reimbursed.
Therefore, healthcare providers should verify the reimbursement status of CPT code 58825 by consulting the MPFS and the relevant MAC's policies to ensure compliance and proper billing practices.
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