CPT code 25071 is for the excision of a lesion on the forearm, subcutaneous, measuring up to 3 cm.
CPT code 25073 is used to describe the surgical procedure for the excision of a deep tumor in the forearm that is 3 centimeters or larger. This code is specifically for cases where the tumor is located deep within the tissues of the forearm, requiring a more complex surgical approach to remove it.
When billing for CPT code 25073 (Excision of deep tumor of the forearm, 3 cm or greater), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to perform the procedure is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both forearms during the same operative session.
3. Modifier 51 - Multiple Procedures: Use this modifier if multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Use this modifier if the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the procedure is distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the same procedure is repeated by a different physician.
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: Use this modifier if the patient requires a 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: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: Use this modifier if an assistant surgeon is required during the procedure.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required during the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier if an assistant surgeon is required and a qualified resident surgeon is not available.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Use this modifier if a non-physician provider assists in the surgery.
14. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left forearm.
15. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right forearm.
These modifiers help provide additional information about the circumstances of the procedure, ensuring accurate billing and reimbursement.
The CPT code 25073 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and guidelines through 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 crucial to consult with your regional Medicare Administrative Contractor (MAC) to ensure compliance with any local coverage determinations (LCDs) or specific billing requirements that may affect reimbursement for CPT code 25073.
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