CPT code 26340 is for manipulating a finger with anesthesia, typically used in procedures to correct joint or tendon issues.
CPT code 26341 is used to describe the procedure of manipulating a cord in the palm of the hand after an injection. This code is typically utilized when a healthcare provider performs a manual adjustment or manipulation of the palmar cord, often following an injection that aims to soften or break down the cord tissue. This procedure is commonly associated with conditions like Dupuytren's contracture, where the cords in the palm can cause fingers to bend towards the palm, limiting hand function.
For CPT code 26341 (Manipulation of palmar fascial cord post-injection), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to perform the procedure is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both hands during the same session, this modifier should be appended.
3. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier should be used to indicate that.
4. Modifier 52 - Reduced Services: If the procedure is partially reduced or eliminated at the physician's discretion, this modifier should be used.
5. 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.
6. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be used.
7. Modifier 77 - Repeat Procedure by Another Physician: If the same procedure is repeated by a different physician, this modifier should be used.
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: Use this modifier if the patient returns 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: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier should be used.
10. Modifier LT - Left Side: Use this modifier to indicate that the procedure was performed on the left hand.
11. Modifier RT - Right Side: Use this modifier to indicate that the procedure was performed on the right hand.
12. Modifier XS - Separate Structure: Use this modifier to indicate that a service was performed on a separate organ/structure.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always refer to the latest CPT and payer guidelines to confirm the appropriate use of modifiers.
The CPT code 26341 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage criteria through 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 crucial to consult with your local Medicare Administrative Contractor (MAC) to ensure compliance with any regional variations or specific guidelines that may affect reimbursement. Each MAC may have unique policies or requirements that could influence the reimbursement process for CPT code 26341.
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