CPT code 24930 is for amputation follow-up surgery, covering the medical procedures needed after an amputation to ensure proper healing.
CPT code 24930 is used to describe a follow-up surgery after an amputation. This code is specifically utilized to document and bill for the medical services provided during a surgical procedure that addresses complications or issues arising from a previous amputation. This could include procedures to revise the amputation site, manage infection, or improve the functionality of the residual limb. Proper use of this code ensures accurate billing and reimbursement for the healthcare provider performing the follow-up surgery.
For CPT code 24930 (Amputation follow-up surgery), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the follow-up surgery required significantly more work 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 unrelated evaluation and management service is performed by the same physician during the postoperative period of the amputation follow-up surgery.
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 a significant, separately identifiable evaluation and management service is provided by the same physician on the same day as the follow-up surgery.
4. Modifier 50 - Bilateral Procedure
- This modifier is used if the follow-up surgery involves bilateral procedures.
5. Modifier 51 - Multiple Procedures
- Apply this modifier if multiple procedures, including the follow-up surgery, are performed during the same surgical session.
6. Modifier 52 - Reduced Services
- Use this modifier if the follow-up surgery was partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure
- This modifier is used if the follow-up surgery was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if the follow-up surgery is a staged or related procedure during the postoperative period of the initial amputation surgery.
9. Modifier 59 - Distinct Procedural Service
- Use this modifier if the follow-up surgery is distinct or independent from other services performed on the same day.
10. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used if the follow-up surgery involves an unplanned return to the operating room for a related procedure during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if the follow-up surgery is unrelated to the initial procedure and occurs during the postoperative period.
12. Modifier 80 - Assistant Surgeon
- Use this modifier if an assistant surgeon is required during the follow-up surgery.
13. Modifier 81 - Minimum Assistant Surgeon
- This modifier is used if a minimum assistant surgeon is required during the follow-up surgery.
14. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Apply this modifier if an assistant surgeon is required because a qualified resident surgeon is not available.
15. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
- Use this modifier if a physician assistant, nurse practitioner, or clinical nurse specialist assists during the follow-up surgery.
Each modifier serves a specific purpose and should be used accurately to ensure proper billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
CPT code 24930 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 and the corresponding payment rates. Additionally, the reimbursement for CPT code 24930 may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region. It is essential to consult the MPFS and your regional MAC guidelines to determine the exact reimbursement details and any additional requirements that may apply.
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