CPT code 61702 is for surgery on a simple intracranial aneurysm using an intracranial approach in the vertebrobasilar circulation.
CPT code 61702 is used to describe a surgical procedure that involves the treatment of a simple intracranial aneurysm using an intracranial approach, specifically targeting the vertebrobasilar circulation. This code is applicable when a surgeon performs an operation to address an aneurysm located in the blood vessels at the base of the brain, which are part of the vertebrobasilar system. The procedure typically involves accessing the aneurysm through the skull to repair or manage the aneurysm, thereby preventing potential complications such as rupture or bleeding.
For CPT code 61702, which pertains to the surgery of a simple intracranial aneurysm via an intracranial approach in the vertebrobasilar circulation, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to increased complexity or additional time spent on the surgery.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was carried out.
3. Modifier 52 - Reduced Services: This modifier is applicable when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure: This is used when a procedure is 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: When two surgeons work together as primary surgeons performing distinct parts of a procedure, this modifier is used.
7. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires the services of several physicians, often of different specialties, working together as a team.
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 is used when a patient requires a 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: This modifier is used when a procedure performed during the postoperative period is unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required to help with the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: This is used when an assistant surgeon is required on a minimal basis.
12. 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.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 61702, which involves a specific surgical procedure, is subject to reimbursement by Medicare, but several factors influence this. Primarily, the Medicare Physician Fee Schedule (MPFS) determines the reimbursement rates for physician services, including surgical procedures. To ascertain if CPT code 61702 is reimbursed, healthcare providers should consult the MPFS to verify if the code is listed and to understand the associated reimbursement rate.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide guidance on coverage policies specific to their jurisdiction. They may have Local Coverage Determinations (LCDs) that affect whether a particular CPT code, such as 61702, is reimbursed based on medical necessity and other criteria.
Therefore, while CPT code 61702 can be reimbursed by Medicare, it is essential for healthcare providers to review the MPFS and consult with their respective MAC to ensure compliance with any specific coverage requirements or documentation needed for successful reimbursement.
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