CPT code 24145 is a medical code used to describe the partial excision of bone in the radial head or neck.
CPT code 24145 is used to describe a partial excision of bone from the radial head or neck. This procedure involves surgically removing a portion of the bone in the radial head or neck area, typically to address issues such as fractures, arthritis, or other conditions that affect the elbow joint. This code is essential for accurately documenting and billing for this specific type of orthopedic surgery.
When billing for CPT code 24145 (Partial excision of bone, radial head or neck), it is essential to consider whether any modifiers are necessary to accurately represent the service provided. Below is a list of potential modifiers that could be used with CPT code 24145, along with 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 factors such as increased complexity or the patient's condition.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the procedure was performed on both the left and right radial head or neck during the same surgical session.
3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures are performed during the same surgical session. This helps indicate that more than one procedure was carried out.
4. Modifier 52 - Reduced Services
- This modifier is appropriate 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 procedure was distinct or independent from other services performed on the same day. This is particularly relevant if the procedures are not typically reported together but are appropriate under the circumstances.
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 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 requires an unplanned return 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 an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier LT - Left Side
- Use this modifier to specify that the procedure was performed on the left side of the body.
11. Modifier RT - Right Side
- Use this modifier to specify that the procedure was performed on the right side of the body.
12. Modifier 99 - Multiple Modifiers
- This modifier is used when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
CPT code 24145 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the allowable payment amounts for various services, including CPT code 24145. Additionally, the reimbursement may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region. It is essential to consult the MPFS and your regional MAC guidelines to determine the exact reimbursement details and any additional requirements for CPT code 24145.
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