CPT code 24576 is a medical code used to describe the treatment of a humerus fracture.
CPT code 24577 is used to describe the surgical treatment of a humerus fracture. This code specifically refers to the procedure where the surgeon performs an open treatment of the fracture, which means making an incision to directly access and repair the broken bone. This may involve the use of hardware such as plates, screws, or rods to stabilize the bone and ensure proper healing. This code is essential for accurate billing and documentation of the surgical intervention required to treat a humerus fracture.
When billing for CPT code 24577, which is used for the treatment of a humerus fracture, certain modifiers may be required to provide additional information about the procedure. Below is a list of potential modifiers that could be used with CPT code 24577, along with the reasons for their use:
1. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period
- Used when an evaluation and management service provided during a postoperative period is unrelated to the original procedure.
3. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
- Used when a significant, separately identifiable evaluation and management service is performed on the same day as the procedure.
4. Modifier 50 - Bilateral Procedure
- Used when the procedure is performed on both sides of the body.
5. Modifier 51 - Multiple Procedures
- Used when multiple procedures are performed during the same session.
6. Modifier 52 - Reduced Services
- Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure
- Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 54 - Surgical Care Only
- Used when only the surgical portion of the service is provided.
9. Modifier 55 - Postoperative Management Only
- Used when only the postoperative care is provided.
10. Modifier 56 - Preoperative Management Only
- Used when only the preoperative care is provided.
11. Modifier 57 - Decision for Surgery
- Used when an evaluation and management service results in the initial decision to perform surgery.
12. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
- Used when a subsequent procedure is planned or anticipated (staged), more extensive than the original procedure, or for therapy following a surgical procedure.
13. 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.
14. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Used when a procedure or service is repeated by the same physician or other qualified healthcare professional.
15. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Used when a procedure or service is repeated by another physician or other qualified healthcare professional.
16. 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 when a patient returns to the operating room for a related procedure during the postoperative period.
17. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Used when an unrelated procedure or service is performed by the same physician during the postoperative period.
18. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during the procedure.
19. Modifier 81 - Minimum Assistant Surgeon
- Used when a minimum assistant surgeon is required during the procedure.
20. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Used when an assistant surgeon is required and a qualified resident surgeon is not available.
21. Modifier 99 - Multiple Modifiers
- Used when two or more modifiers are necessary to describe the service provided.
These modifiers help to provide a more complete picture of the services rendered and ensure accurate billing and reimbursement. Always refer to the latest CPT coding guidelines and payer-specific requirements for the most accurate and up-to-date information.
CPT code 24577 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered under Medicare Part B, including CPT code 24577. To determine the exact reimbursement rate for this code, healthcare providers should refer to the MPFS, which is updated annually.
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 information regarding coverage and reimbursement rates for CPT code 24577. Providers should consult their respective MAC for detailed guidance on billing and reimbursement for this specific code.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 24577. Ensure you're receiving the full reimbursement you deserve from each payer. Schedule a demo today to see RevFind in action and protect your revenue.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
