CPT code 24351 is for the surgical repair of tennis elbow, a procedure to alleviate pain and restore function in the elbow joint.
CPT code 24351 is used for the surgical repair of tennis elbow, a condition also known as lateral epicondylitis. This procedure involves the surgeon making an incision to access the affected tendons and tissues around the elbow, removing any damaged tissue, and reattaching healthy tissue to the bone. The goal is to alleviate pain and restore function to the elbow.
For CPT code 24351, which pertains to the repair of tennis elbow, the following modifiers may be applicable:
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 other factors that increase the complexity of the procedure.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both elbows during the same operative session.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session. This modifier indicates that the procedure is one of several performed.
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: 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 if the same procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: Used if the same procedure is 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: 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: Used if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required for the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required 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.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services provided.
CPT code 24351 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. However, it is important to note that the final determination of reimbursement for CPT code 24351 may also depend on the policies of the Medicare Administrative Contractor (MAC) that services your geographic region. MACs have the authority to implement local coverage determinations (LCDs) that can affect whether and how a particular CPT code is reimbursed. Therefore, it is advisable to consult both the MPFS and your regional MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 24351.
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