CPT code 24345 is for the surgical repair of the elbow's medial ligament using tissue.
CPT code 24346 is used to describe the surgical procedure for reconstructing the medial collateral ligament of the elbow. This procedure is typically performed to repair or replace a damaged ligament, often due to injury or overuse, to restore stability and function to the elbow joint.
For CPT code 24346 (Reconstruct elbow medial collateral ligament), 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. This could be due to complications or additional work during the reconstruction.
2. Modifier 50 (Bilateral Procedure): If the procedure is performed on both elbows during the same surgical session, this modifier should be appended.
3. Modifier 51 (Multiple Procedures): If multiple procedures are performed during the same surgical session, this modifier indicates that multiple services were provided.
4. Modifier 52 (Reduced Services): Used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 (Distinct Procedural Service): Indicates that the procedure is distinct or independent from other services performed on the same day. This is used to avoid bundling issues.
6. Modifier 76 (Repeat Procedure by Same Physician): If the same procedure is repeated by the same physician on the same day, this modifier should be used.
7. Modifier 77 (Repeat Procedure by Another Physician): If the procedure is repeated by a different physician on the same day, this modifier is applicable.
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 if the patient needs 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): If an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): If an assistant surgeon is required for the procedure, this modifier should be appended.
11. Modifier 81 (Minimum Assistant Surgeon): Used when an assistant surgeon provides minimal assistance.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
13. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery): Used when these non-physician practitioners assist in the surgery.
14. Modifier LT (Left Side): Indicates that the procedure was performed on the left elbow.
15. Modifier RT (Right Side): Indicates that the procedure was performed on the right elbow.
These modifiers help provide additional information about the circumstances of the procedure and ensure accurate billing and reimbursement.
CPT code 24346 is reimbursed by Medicare, but the reimbursement specifics can vary. To determine if this particular CPT code is covered and the amount reimbursed, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. Additionally, it is essential to consult with your regional Medicare Administrative Contractor (MAC), as they are responsible for processing Medicare claims and can provide guidance on any local coverage determinations or specific billing requirements related to CPT code 24346.
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