CPT code 10140 is for the drainage of a hematoma or fluid, a procedure to remove accumulated blood or fluid from a specific area.
CPT code 10140 is used for the procedure involving the drainage of a hematoma or fluid collection. This code is typically applied when a healthcare provider needs to remove accumulated blood (hematoma) or other fluids from a specific area of the body to relieve pressure, reduce pain, or prevent infection. The procedure usually involves making a small incision to allow the fluid to drain out, which can be done in various settings such as a clinic, hospital, or outpatient facility.
When using CPT code 10140 for the drainage of hematoma/fluid, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers and the reasons for their use:
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.
2. Modifier 24 (Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period)
- Apply this modifier if an unrelated evaluation and management service is performed by the same physician during the postoperative period of the initial procedure.
3. Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service)
- Use this modifier when a significant, separately identifiable evaluation and management service is performed by the same physician on the same day as the procedure.
4. Modifier 50 (Bilateral Procedure)
- This modifier is used if the procedure is performed bilaterally.
5. Modifier 51 (Multiple Procedures)
- Apply this modifier when multiple procedures are performed during the same session. This indicates that the procedure is one of several performed.
6. Modifier 52 (Reduced Services)
- Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
7. Modifier 53 (Discontinued Procedure)
- This modifier is used if the procedure was discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 59 (Distinct Procedural Service)
- Apply this modifier to indicate that the procedure is distinct or independent from other services performed on the same day.
9. 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 physician or other qualified healthcare professional.
10. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional)
- This modifier is used if the same procedure is repeated by a different physician or other qualified healthcare professional.
11. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period)
- Apply this modifier if the patient returns to the operating room for a related procedure during the postoperative period.
12. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period)
- Use this modifier if an unrelated procedure or service is performed by the same physician during the postoperative period.
13. Modifier 80 (Assistant Surgeon)
- This modifier is used if an assistant surgeon is required for the procedure.
14. Modifier 81 (Minimum Assistant Surgeon)
- Apply this modifier if a minimum assistant surgeon is required for the procedure.
15. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available))
- Use this modifier if an assistant surgeon is required because a qualified resident surgeon is not available.
16. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery)
- This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each of these modifiers provides additional information about the circumstances under which CPT code 10140 was used, ensuring accurate billing and appropriate reimbursement.
The CPT code 10140 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services covered by Medicare, and it is essential to verify the current rates and guidelines as they can change annually.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and reimbursement policies for CPT code 10140. Each MAC may have specific requirements or documentation standards that must be met for the service to be reimbursed. Therefore, it is advisable to consult the relevant MAC for detailed information on coverage and reimbursement criteria for CPT code 10140.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can read your contracts and detect underpayments down to the CPT code level, including specific codes like 10140. Don't let underpayments slip through the cracks—schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
