CPT code 26060 is a medical code used to describe the procedure for an incision of a finger tendon.
CPT code 26060 is for the surgical procedure involving the incision of a finger tendon. This code is used when a healthcare provider makes a precise cut into a tendon in the finger, often to relieve tension, remove a blockage, or repair damage. This procedure is typically performed to restore function and alleviate pain in the affected finger.
For CPT code 26060, which pertains to the incision of a finger tendon, 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.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both hands.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician: Used when 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: Used when a related procedure is performed during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period.
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: Used to indicate a service that is distinct because it was performed on a separate organ/structure.
13. Modifier XE - Separate Encounter: Used to indicate a service that is distinct because it occurred during a separate encounter.
14. Modifier XP - Separate Practitioner: Used to indicate a service that is distinct because it was performed by a different practitioner.
15. Modifier XU - Unusual Non-Overlapping Service: Used to indicate a service that is distinct because it does not overlap usual components of the main service.
These modifiers help provide additional information about the procedure and ensure accurate billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
CPT code 26060 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. To determine if CPT 26060 is covered and the reimbursement rate, healthcare providers should refer to 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 essential to consult with the relevant Medicare Administrative Contractor (MAC) for your region. MACs are responsible for processing Medicare claims and can provide specific guidance on coverage policies, local coverage determinations (LCDs), and any documentation requirements that may affect reimbursement for CPT code 26060. By checking both the MPFS and consulting with your MAC, you can ensure accurate billing and optimal reimbursement for this CPT code.
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