CPT code 24670 is used for the treatment of an ulnar fracture, detailing the specific medical procedure performed to repair the bone.
CPT code 24675 is used to describe the surgical treatment of an ulnar fracture. This code specifically refers to the procedure where a healthcare provider repairs a break in the ulna, one of the two long bones in the forearm. The treatment typically involves aligning the bone fragments and securing them with hardware such as plates, screws, or rods to ensure proper healing. This code is essential for accurate billing and documentation of the surgical intervention required to treat the fracture.
For CPT code 24675, which pertains to the treatment of an ulnar fracture, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to treat the ulnar fracture is substantially greater than typically required. This could be due to complications or unusual circumstances.
2. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: Apply this modifier if an evaluation and management service was performed during the postoperative period of the ulnar fracture treatment, but the service 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: Use this modifier if an evaluation and management service was provided on the same day as the ulnar fracture treatment, and it is significant and separately identifiable from the procedure.
4. Modifier 50 - Bilateral Procedure: This modifier is used if the treatment was performed on both ulnar bones in a bilateral procedure.
5. Modifier 51 - Multiple Procedures: Apply this modifier if multiple procedures were performed during the same surgical session as the ulnar fracture treatment.
6. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure: This modifier is applicable if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 54 - Surgical Care Only: Use this modifier if the physician is providing only the surgical care portion of the treatment.
9. Modifier 55 - Postoperative Management Only: Apply this modifier if the physician is providing only the postoperative management portion of the treatment.
10. Modifier 56 - Preoperative Management Only: This modifier is used if the physician is providing only the preoperative management portion of the treatment.
11. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if a subsequent procedure was planned or anticipated at the time of the original procedure.
12. Modifier 59 - Distinct Procedural Service: Apply this modifier if the treatment of the ulnar fracture was distinct or independent from other services performed on the same day.
13. Modifier 76 - Repeat Procedure or Service by Same Physician: Use this modifier if the same procedure was repeated by the same physician.
14. Modifier 77 - Repeat Procedure by Another Physician: This modifier is applicable if the same procedure was repeated by a different physician.
15. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier if the patient had to return to the operating room for a related procedure during the postoperative period.
16. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Apply this modifier if an unrelated procedure was performed by the same physician during the postoperative period.
17. Modifier 80 - Assistant Surgeon: This modifier is used if an assistant surgeon was required during the procedure.
18. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon was required during the procedure.
19. 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.
20. Modifier 99 - Multiple Modifiers: This modifier is used if multiple modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the circumstances of the procedure and ensure accurate billing and reimbursement.
The CPT code 24675 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment rates. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and guidelines that affect payment. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 24675.
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