CPT code 25375 is a medical code used to describe the surgical revision of the radius and ulna bones in the forearm.
CPT code 25390 is used to describe a surgical procedure that involves shortening either the radius or the ulna, which are the two long bones in the forearm. This procedure is typically performed to correct deformities, improve function, or alleviate pain caused by conditions such as fractures, congenital abnormalities, or other orthopedic issues.
When using CPT code 25390 for shortening the radius or ulna, certain modifiers may be necessary to provide additional information about the procedure. Below is a list of potential modifiers that could be used with CPT code 25390, along with the reasons for their use:
1. Modifier 22 (Increased Procedural Services): Used when the work required to perform the procedure is substantially greater than typically required. This could be due to complications or other factors that increase the complexity of the surgery.
2. Modifier 50 (Bilateral Procedure): Applied if the procedure is performed on both the radius and ulna in the same session.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This helps in indicating that more than one procedure was carried out.
4. Modifier 52 (Reduced Services): Applied if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 59 (Distinct Procedural Service): Used to indicate that the procedure is distinct or independent from other services performed on the same day. This is particularly useful if multiple procedures are performed that are not typically reported together.
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): Applied if the 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): Applied if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier LT (Left Side): Used to specify that the procedure was performed on the left side of the body.
11. Modifier RT (Right Side): Used to specify that the procedure was performed on the right side of the body.
12. Modifier XS (Separate Structure): Indicates that a service was performed on a separate organ/structure.
13. Modifier XE (Separate Encounter): Used to indicate that a service was performed during a separate encounter.
14. Modifier XP (Separate Practitioner): Applied when a service is performed by a different practitioner.
15. Modifier XU (Unusual Non-Overlapping Service): Used to indicate that a service does not overlap usual components of the main service.
These modifiers help in providing a more accurate and detailed description of the services rendered, ensuring proper billing and reimbursement.
CPT code 25390 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 reimbursement rates. Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 25390.
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