CPT code 24305 is for a surgical procedure involving the lengthening of a tendon in the upper arm or elbow for each tendon.
CPT code 24305 is used to describe a surgical procedure for tendon lengthening in the upper arm or elbow area for each tendon involved. This code is typically utilized when a surgeon needs to lengthen a tendon to improve the range of motion or function in the affected area.
For CPT code 24305 (Tendon lengthening, upper arm and elbow, each tendon), the following modifiers may be applicable:
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 50 (Bilateral Procedure): If the tendon lengthening procedure is performed on both arms, this modifier should be used to indicate a bilateral procedure.
3. Modifier 51 (Multiple Procedures): If multiple procedures are performed during the same surgical session, this modifier should be used to indicate that more than one procedure was performed.
4. 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 often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier LT (Left Side): If the procedure is performed on the left arm, this modifier should be used to specify the side of the body.
6. Modifier RT (Right Side): If the procedure is performed on the right arm, this modifier should be used to specify the side of the body.
7. Modifier 76 (Repeat Procedure by Same Physician): Use this modifier if the same procedure is repeated by the same physician on the same day.
8. Modifier 77 (Repeat Procedure by Another Physician): Use this modifier if the same procedure is repeated by a different physician on the same day.
9. 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 needs to return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
11. Modifier 80 (Assistant Surgeon): If an assistant surgeon is required for the procedure, this modifier should be used.
12. Modifier 81 (Minimum Assistant Surgeon): Use this modifier if a minimum assistant surgeon is required for the procedure.
13. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
14. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): Use this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
These modifiers help provide additional information about the circumstances of the procedure and ensure accurate billing and reimbursement.
CPT code 24305 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates. To determine the exact reimbursement for CPT code 24305, healthcare providers should consult the MPFS for the current year.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide region-specific guidelines and policies that may affect the reimbursement of CPT code 24305. It is advisable for healthcare providers to check with their respective MAC to ensure compliance with any local coverage determinations (LCDs) or other relevant policies that might impact the reimbursement for this specific CPT code.
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