CPT code 61750 is for a procedure involving a precise biopsy, aspiration, or removal of a brain lesion using a small opening in the skull.
CPT code 61750 is used to describe a medical procedure involving a stereotactic biopsy, aspiration, or excision of an intracranial lesion. This procedure is performed using a minimally invasive technique that involves creating one or more small openings, known as burr holes, in the skull. The stereotactic approach allows for precise targeting of the lesion within the brain, guided by imaging technology, to obtain tissue samples, remove fluid, or excise the lesion. This code is typically used by neurosurgeons and other specialists to document and bill for this specific type of intracranial procedure.
For CPT code 61750, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to increased complexity or time.
2. Modifier 51 - Multiple Procedures: Apply this modifier when multiple procedures are performed during the same surgical session. This indicates that more than one procedure was performed.
3. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
4. 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.
5. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier should be used.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: Use this modifier if the same procedure is repeated by the same provider.
7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This is used when the procedure is repeated by a different provider.
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 applicable 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: Use this modifier when an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Use this when a minimum assistant surgeon is required.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This is applicable when an assistant surgeon is necessary due to the unavailability of a qualified resident.
13. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary, this modifier indicates that multiple modifiers are being used.
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 61750 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, it's important to note that the reimbursement for CPT code 61750 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting local coverage determinations, which can influence whether and how much Medicare reimburses for this particular code.
Therefore, healthcare providers should consult their specific MAC for detailed information on reimbursement rates and any additional requirements that may apply to CPT code 61750.
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