CPT code 24105 is for the surgical excision of the olecranon bursa, a procedure to remove the fluid-filled sac near the elbow.
CPT code 24110 is used to describe the surgical procedure for the excision or curettage of a bone cyst or benign tumor in the humerus. This code is specifically for procedures involving the upper arm bone, where a surgeon removes or scrapes out a non-cancerous growth or cyst from the bone. This type of procedure is typically performed to alleviate pain, prevent fractures, or address other complications associated with the bone cyst or benign tumor.
When billing for CPT code 24110 (Excision or curettage of bone cyst or benign tumor of the humerus), 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 provide a service is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by another physician.
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: Used when a related procedure is performed during the postoperative period.
9. 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.
10. Modifier LT - Left Side: Used to specify that the procedure was performed on the left side of the body.
11. Modifier RT - Right Side: Used to specify that the procedure was performed on the right side of the body.
12. Modifier 99 - Multiple Modifiers: Used when two or more modifiers are necessary to describe the service.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
The CPT code 24110 is reimbursed by Medicare, but it is essential to verify the specifics 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. Additionally, MACs may have localized guidelines and policies that could affect reimbursement. Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 24110.
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 24110, and by individual payer. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.
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