CPT code 62190 is for creating a shunt connecting subarachnoid or subdural spaces to the atrial, jugular, or auricular areas.
CPT code 62190 is used to describe the surgical procedure for creating a shunt that connects the subarachnoid or subdural space to the atrial, jugular, or auricular areas. This procedure is typically performed to relieve pressure caused by excess cerebrospinal fluid (CSF) accumulation, which can occur in conditions such as hydrocephalus. By redirecting the CSF to another part of the body where it can be absorbed, the shunt helps to maintain normal pressure levels within the brain. This code is essential for healthcare providers to accurately document and bill for this specific type of neurosurgical intervention.
For CPT code 62190, 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 complications or unusual circumstances during the surgery.
2. Modifier 51 (Multiple Procedures): Apply this modifier if multiple procedures were performed during the same surgical session. It indicates that the procedure was one of several performed.
3. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day. It is often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 62 (Two Surgeons): Use this modifier when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure.
5. Modifier 66 (Surgical Team): Apply this modifier if the procedure required a surgical team due to its complexity.
6. Modifier 76 (Repeat Procedure by Same Physician): Use this modifier if the same physician repeats the procedure on the same day.
7. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when a procedure is repeated by a different physician on the same day.
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): Use this modifier 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): Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 (Assistant Surgeon): Use this modifier when an assistant surgeon is required for the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when an assistant surgeon is required for a minimal portion of the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Use this modifier when an assistant surgeon is required, and 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. Always verify with the latest coding guidelines and payer-specific requirements.
The CPT code 62190 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). Whether this code is reimbursed by Medicare depends on several factors, including the specific guidelines and policies set forth by the Medicare Administrative Contractor (MAC) that governs the region where the service is provided.
Each MAC may have different coverage determinations and reimbursement rates for CPT code 62190, based on local coverage determinations (LCDs) and national coverage determinations (NCDs). Therefore, it is essential for healthcare providers to verify the reimbursement status and any specific billing requirements with their respective MAC to ensure compliance and proper reimbursement for services rendered under this code.
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