CPT code 26140 is for the surgical revision of a finger joint, involving the correction or improvement of a previous procedure.
CPT code 26140 is used to describe a surgical procedure where a healthcare provider revises or corrects a joint in the finger. This could involve removing or repairing damaged tissue, realigning the joint, or other surgical interventions to improve joint function and alleviate pain. This code is specific to procedures performed on finger joints, ensuring accurate billing and documentation for the services provided.
When billing for CPT code 26140 (Revise finger joint each), it is essential to consider the appropriate modifiers to ensure accurate reimbursement and compliance with payer requirements. Below is a list of potential modifiers that could be used with CPT code 26140, along with the reasons for their use:
1. Modifier 50 - Bilateral Procedure
- Use this modifier if the procedure is performed on both hands during the same session.
2. Modifier 51 - Multiple Procedures
- Apply this modifier when multiple procedures are performed during the same surgical session.
3. 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.
4. Modifier 76 - Repeat Procedure by Same Physician
- This modifier is used if the same procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier if the procedure is repeated by a different physician on the same day.
6. 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 returns to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
8. Modifier LT - Left Side (Used to identify procedures performed on the left side of the body)
- Apply this modifier if the procedure is performed on the left hand.
9. Modifier RT - Right Side (Used to identify procedures performed on the right side of the body)
- Use this modifier if the procedure is performed on the right hand.
10. Modifier XS - Separate Structure
- This modifier is used to indicate that a service is distinct because it was performed on a separate organ/structure.
11. Modifier XE - Separate Encounter
- Use this modifier to indicate that a service is distinct because it was performed during a separate encounter.
12. Modifier XP - Separate Practitioner
- Apply this modifier to indicate that a service is distinct because it was performed by a different practitioner.
13. Modifier XU - Unusual Non-Overlapping Service
- This modifier is used to indicate that a service is distinct because it does not overlap usual components of the main service.
By appropriately applying these modifiers, healthcare providers can ensure that their claims for CPT code 26140 are accurately processed and reimbursed.
The CPT code 26140 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 crucial to consult with your local Medicare Administrative Contractor (MAC) to confirm any regional variations or specific guidelines that may affect reimbursement for CPT code 26140. The MACs are responsible for processing Medicare claims and can provide detailed information on coverage and payment policies in your area.
Discover how MD Clarity's RevFind software can meticulously read your contracts and detect underpayments down to the CPT code level and by individual payer. For instance, RevFind can identify discrepancies for specific procedures like CPT code 26140. Schedule a demo today to see how RevFind ensures you receive every dollar you're owed.
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