CPT code 25922 is used for the surgical procedure to amputate a hand at the wrist.
CPT code 25924 is used to describe a surgical procedure for follow-up care after an amputation. This code specifically pertains to any additional surgery required to address complications, refine the amputation site, or improve the patient's overall functionality and comfort post-amputation.
For CPT code 25924, which pertains to amputation follow-up surgery, the following modifiers may be applicable depending on the specific circumstances of the procedure:
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 follow-up surgery involves both limbs. This modifier indicates that the procedure was performed on both sides of the body.
3. Modifier 51 (Multiple Procedures): Used when multiple procedures are performed during the same surgical session. This modifier helps to indicate that more than one procedure was carried out.
4. Modifier 52 (Reduced Services): Applied when the procedure is partially reduced or eliminated at the physician's discretion. This could occur if the full scope of the follow-up surgery was not necessary.
5. Modifier 58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): Used if the follow-up surgery is planned or staged, or if it is more extensive than the original procedure.
6. Modifier 59 (Distinct Procedural Service): Applied to indicate that the follow-up surgery was distinct or independent from other services performed on the same day.
7. Modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional): Used if the follow-up surgery is a repeat of the same procedure performed by the same physician.
8. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied if the follow-up surgery is a repeat of the same procedure but performed by a different physician.
9. 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 follow-up surgery is an unplanned return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Applied if the follow-up surgery is unrelated to the original procedure and occurs during the postoperative period.
11. Modifier 80 (Assistant Surgeon): Used if an assistant surgeon is required during the follow-up surgery.
12. Modifier 81 (Minimum Assistant Surgeon): Applied if a minimum assistant surgeon is required during the follow-up surgery.
13. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used if an assistant surgeon is required because a qualified resident surgeon is not available.
14. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): Applied if a physician assistant, nurse practitioner, or clinical nurse specialist assists during the follow-up surgery.
These modifiers help to provide additional context and detail about the specific circumstances under which CPT code 25924 is used, ensuring accurate billing and reimbursement.
The CPT code 25924 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment amounts. Additionally, reimbursement for CPT code 25924 may vary depending on the region, as Medicare Administrative Contractors (MACs) have the authority to make local coverage determinations. Therefore, it is advisable to consult the relevant MAC for your area to confirm the reimbursement details for CPT code 25924.
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