CPT code 60200 is a medical code used to describe the procedure for removing a thyroid lesion, helping healthcare providers document and communicate services.
CPT code 60200 is used to designate the surgical removal of a lesion from the thyroid gland, focusing on excising the targeted thyroid tissue while minimizing impact on overall thyroid function.
For the CPT code 60200, which involves the removal of a thyroid lesion, 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: This is used when multiple procedures are performed during the same surgical session. It indicates that the procedure is one of several performed.
3. Modifier 52 - Reduced Services: This modifier is applicable when a service or procedure is partially reduced or eliminated at the physician's discretion. Documentation should support the reduction in service.
4. Modifier 59 - Distinct Procedural Service: This is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician subsequent to the original procedure.
6. Modifier 77 - Repeat Procedure by Another Physician: This is used when a procedure is repeated by a different physician than the one who performed the original procedure.
7. 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.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
9. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required during the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: This is used when an assistant surgeon is required for a minimal portion of the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
12. Modifier 99 - Multiple Modifiers: This is used when two or more modifiers are necessary to describe the service provided accurately.
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. Proper documentation is crucial to justify the use of any modifier.
The CPT code 60200 is subject to reimbursement by Medicare, but it is essential to verify its status on the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate and any applicable guidelines. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment rates. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) are responsible for processing claims and may have specific local coverage determinations that affect reimbursement. Therefore, healthcare providers should consult the MPFS and their respective MAC to ensure accurate billing and reimbursement for CPT code 60200.
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