CPT code 26123 is a medical code used to describe the procedure for releasing a contracture in the palm.
CPT code 26123 is used to describe a surgical procedure that involves the release of a contracture in the palm. This procedure is typically performed to improve hand function and alleviate discomfort caused by the tightening or shortening of the tissues in the palm, which can restrict movement and flexibility.
For CPT code 26123 (Release palm contracture), 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 provide a service is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both hands during the same session.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when a service or 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 circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 26123 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 respective payment rates. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) are responsible for processing claims and determining coverage specifics in their respective jurisdictions. Therefore, it is advisable to consult the MPFS and the relevant MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 26123.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 26123. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
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