CPT code 24102 is a medical billing code for arthrotomy of the elbow with synovectomy, used to describe and bill for this specific surgical procedure.
CPT code 24105 is used to describe the surgical procedure for the excision, or removal, of the olecranon bursa. The olecranon bursa is a small fluid-filled sac located at the tip of the elbow, which can become inflamed or infected, causing pain and swelling. This code is specifically used when a healthcare provider performs surgery to remove this bursa to alleviate symptoms and improve the patient's elbow function.
When billing for CPT code 24105 (Excision olecranon bursa), it is essential to consider the appropriate use of modifiers to ensure accurate reimbursement and compliance with payer requirements. Below is a list of potential modifiers that could be used with CPT code 24105, along with the reasons for their use:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly greater effort or complexity than typically required.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the excision of the olecranon bursa was performed on both elbows during the same operative session.
3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures, including the excision of the olecranon bursa, are performed during the same surgical session.
4. Modifier 52 - Reduced Services
- This modifier is applicable if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service
- Use this modifier to indicate that the excision of the olecranon bursa was a distinct procedural service from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician
- Apply this modifier if the same procedure was repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician
- Use this modifier if the same procedure was 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
- This modifier is used if the patient returns 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 the excision of the olecranon bursa is performed during the postoperative period of another unrelated procedure.
10. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon was required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Apply this modifier if a minimum assistant surgeon was required during the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Use this modifier if an assistant surgeon was required because a qualified resident surgeon was not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- This modifier is used when a non-physician provider assists in the surgery.
14. Modifier LT - Left Side (used to identify procedures performed on the left side of the body)
- Apply this modifier if the excision was performed on the left elbow.
15. Modifier RT - Right Side (used to identify procedures performed on the right side of the body)
- Use this modifier if the excision was performed on the right elbow.
Proper use of these modifiers ensures that the billing accurately reflects the services provided, which can help in avoiding claim denials and ensuring appropriate reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
CPT code 24105 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, including the reimbursement rates for each CPT code. Additionally, MACs are responsible for processing Medicare claims and can offer region-specific guidance on reimbursement policies. Therefore, to ensure accurate and up-to-date information regarding the reimbursement of CPT code 24105, healthcare providers should consult both the MPFS and their respective MAC.
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