CPT code 24332 is for the surgical procedure of tenolysis of the triceps, which involves releasing a tendon to improve movement.
CPT code 24340 is a medical billing code used to describe the surgical procedure known as tenodesis of the biceps tendon at the elbow. This procedure involves the reattachment of the biceps tendon to the bone in the elbow area, typically to address issues such as tendonitis or a tendon tear. By using this specific CPT code, healthcare providers can accurately document and bill for this particular surgical intervention.
When billing for CPT code 24340 (Tenodesis biceps tendon at elbow), 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 24340, 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. Documentation must support the additional effort.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the tenodesis procedure was performed on both elbows 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 done.
4. Modifier 52 - Reduced Services
- Apply this modifier 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.
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 Room
- Apply this modifier if the patient had to 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
- Use this modifier if an unrelated procedure was performed by the same physician during the postoperative period of the initial procedure.
10. Modifier LT - Left Side
- Apply this modifier if the procedure was performed on the left elbow.
11. Modifier RT - Right Side
- Use this modifier if the procedure was performed on the right elbow.
12. Modifier 80 - Assistant Surgeon
- Apply this modifier if an assistant surgeon was required during the procedure.
13. Modifier 81 - Minimum Assistant Surgeon
- Use this modifier if a minimum assistant surgeon was required during the procedure.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier if an assistant surgeon was necessary because a qualified resident surgeon was not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Use this modifier if a PA, NP, or CNS assisted during the surgery.
Proper use of these modifiers can help ensure that claims are processed correctly and that the healthcare provider receives appropriate reimbursement for the services rendered. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
The CPT code 24340 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, along with the corresponding reimbursement rates. To determine the exact reimbursement for CPT code 24340, healthcare providers should consult the MPFS for the current year.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing claims and determining coverage specifics for their respective jurisdictions. Each MAC may have localized policies or additional documentation requirements that could affect the reimbursement process for CPT code 24340. Therefore, it is advisable for healthcare providers to verify with their respective MAC to ensure compliance with all necessary guidelines and to obtain accurate reimbursement information.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and identify underpayments down to the CPT code level, including specific codes like 24340. Ensure you're receiving accurate reimbursements from every payer. Schedule a demo today to see RevFind in action and protect your revenue.
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