CPT Code 66174

CPT code 66174 is a medical procedure code for trans-luminal dilation of the aqueous outflow canal without stent.

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What is CPT Code 66174

CPT code 66174 is a medical procedure code that describes a transliminal dilation of the aqueous outflow canal without the use of an implant. This procedure is typically performed to treat conditions like glaucoma by enhancing the drainage of aqueous fluid from the eye to reduce intraocular pressure.

Does CPT 66174 Need a Modifier?

For CPT code 66174 (Transluminal dilation of aqueous outflow canal; without retention of device or stent), the application of modifiers can be essential depending on the specific circumstances of the procedure and billing requirements. Here are some commonly applicable modifiers and the reasons for their use:

1. -26 Professional Component: This modifier is used when only the professional component of the procedure is being billed, meaning the service provided by the physician, excluding any facility fees.

2. -TC Technical Component: Conversely, this modifier is used when only the technical component of the procedure is being billed. This would apply if the physician is billing only for the use of equipment or facilities.

3. -50 Bilateral Procedure: If the procedure is performed on both eyes during the same operative session, this modifier should be used to indicate a bilateral service.

4. -59 Distinct Procedural Service: This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day. This could be necessary if the procedure is performed in conjunction with other similar procedures.

5. -76 Repeat Procedure by Same Physician: Use this modifier if the procedure needs to be repeated on the same day by the same physician, indicating a separate session.

6. -77 Repeat Procedure by Another Physician: Similar to -76, but used if the procedure is repeated by a different physician on the same day.

7. -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 if the patient must return to the operating room for a related procedure that was unplanned but related to the original procedure.

8. -79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If a completely unrelated procedure is performed by the same physician during the postoperative period of the initial procedure, this modifier should be used.

9. -XS Separate Structure: This modifier is used to specify that the procedure was performed on a separate anatomical structure (e.g., the other eye).

10. -XU Unusual Non-Overlapping Service: This modifier indicates that the procedure is unusual and non-overlapping, used to bypass a usual bundling rule.

Each of these modifiers serves to provide specific information that affects how billing and reimbursement are handled, ensuring that the services rendered are accurately documented and compensated.

CPT Code 66174 Medicare Reimbursement

CPT code 66174 (Transluminal dilation of aqueous outflow canal; without retention of device or stent) is generally reimbursed by Medicare. However, the specific amount of reimbursement can vary based on the geographic location and the setting in which the procedure is performed (e.g., outpatient hospital, ambulatory surgery center, etc.). It's important for healthcare providers to check the Medicare Physician Fee Schedule (MPFS) or contact their local Medicare Administrative Contractor (MAC) for precise reimbursement rates applicable to their region and practice setting.

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