CPT code 62192 is for creating a shunt from the subarachnoid or subdural space to the peritoneal, pleural, or another terminus.
CPT code 62192 is used to describe the surgical procedure for creating a shunt that connects the subarachnoid or subdural space to another part of the body, such as the peritoneal cavity, pleural space, or another designated terminus. This procedure is typically performed to relieve pressure or drain excess cerebrospinal fluid, often in cases of hydrocephalus or other conditions that cause fluid accumulation in the brain. The shunt helps redirect the fluid to another area where it can be absorbed or drained, thereby alleviating symptoms and preventing complications.
For CPT code 62192, 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 effort or time than typically required.
2. Modifier 51 (Multiple Procedures): Apply this modifier if multiple procedures were performed during the same surgical session.
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 76 (Repeat Procedure by Same Physician): Use this modifier if the same procedure was repeated by the same physician.
6. Modifier 77 (Repeat Procedure by Another Physician): Apply this modifier if the procedure was repeated by a different physician.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room): Use this modifier if the patient had to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
9. Modifier 80 (Assistant Surgeon): Use this modifier if an assistant surgeon was necessary for the procedure.
10. Modifier 81 (Minimum Assistant Surgeon): Apply this modifier if a minimum assistant surgeon was required.
11. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Use this modifier when an assistant surgeon is required due to the unavailability of a qualified resident surgeon.
12. Modifier 99 (Multiple Modifiers): Use this modifier when more than four modifiers are necessary to describe the service.
Each modifier should be used in accordance with the specific guidelines and payer requirements to ensure accurate billing and reimbursement.
CPT code 62192 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the policies set forth by the respective Medicare Administrative Contractor (MAC) in your region.
The MPFS provides a comprehensive list of services covered by Medicare, along with the associated payment rates. However, the final decision on reimbursement can also depend on local coverage determinations (LCDs) made by MACs, which may vary based on geographic location and specific medical necessity criteria.
Therefore, healthcare providers should verify the reimbursement status of CPT code 62192 with their local MAC to ensure compliance with Medicare's billing requirements and to understand any specific documentation or pre-authorization requirements that may apply.
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