CPT code 20662 is a medical code used to describe the application of a pelvis brace for healthcare billing and documentation purposes.
CPT code 20662 is for the application of a pelvis brace. This code is used when a healthcare provider fits and applies a brace to the pelvic area to provide support and stabilization, often necessary after an injury or surgery.
For CPT code 20662, "Application of pelvis brace," the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.
3. Modifier 53 - Discontinued Procedure: Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
4. Modifier 59 - Distinct Procedural Service: Indicates 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: Used when the same procedure is repeated by the same physician.
6. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Indicates an unplanned 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: Used when an unrelated procedure is performed by the same physician during the postoperative period.
9. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was involved in the procedure.
10. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon provides minimal assistance.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Indicates that a non-physician provider assisted in the surgery.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
When it comes to the reimbursement of CPT code 20662, which pertains to the application of a pelvis brace, Medicare does provide coverage under certain conditions. The reimbursement is contingent upon the medical necessity and the specific circumstances of the patient's condition.
Medicare typically covers durable medical equipment (DME) like braces if they are deemed medically necessary by a healthcare provider. However, the exact reimbursement amount can vary based on several factors, including the geographic location, the specific Medicare plan, and whether the service is performed in a hospital outpatient setting or a physician's office.
As of the latest available data, the national average reimbursement rate for CPT code 20662 under Medicare is approximately $150-$200. However, it is crucial to verify the exact amount with the local Medicare Administrative Contractor (MAC) as rates can fluctuate.
For the most accurate and up-to-date information, healthcare providers should consult the Medicare Fee Schedule or contact their local MAC. This ensures that they are billing correctly and receiving appropriate reimbursement for the services rendered.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 20662 for the application of a pelvis brace. Ensure you're receiving the full reimbursement you deserve from each payer. Schedule a demo today to see RevFind in action and protect your revenue.
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