CPT code 26390 is a medical code used to describe the surgical procedure for revising a tendon in the hand or finger.
CPT code 26390 is used for the surgical procedure to revise a tendon in the hand or finger. This involves making adjustments or repairs to the tendon to restore its function, which may be necessary due to injury, disease, or previous surgical complications. The goal of this procedure is to improve movement and reduce pain in the affected hand or finger.
For CPT code 26390 (Revise hand/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 provide a service is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both hands or fingers 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 another 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 indicate that the procedure was performed on the left hand or finger.
11. Modifier RT - Right Side: Used to indicate that the procedure was performed on the right hand or finger.
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 consult the latest coding guidelines and payer-specific requirements to determine the appropriate use of modifiers.
CPT code 26390 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 payment rates. Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and guidelines. Therefore, it is advisable to consult the relevant MAC for your area to ensure accurate and up-to-date information regarding the reimbursement of CPT code 26390.
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