CPT code 26445 is a medical code used to describe the surgical release of a tendon in the hand or finger.
CPT code 26445 is used to describe a surgical procedure that involves the release of a tendon in the hand or finger. This procedure is typically performed to alleviate conditions such as trigger finger or tendon entrapment, where the tendon becomes constricted and causes pain or limited movement. By releasing the tendon, the surgeon aims to restore normal function and relieve discomfort in the affected hand or finger.
For CPT code 26445 (Release 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 perform the procedure is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both hands or both sets of 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 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 if the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician: Used if 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 of the initial procedure.
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 of the initial procedure.
10. Modifier LT - Left Side: Used to specify that the procedure was performed on the left hand or fingers.
11. Modifier RT - Right Side: Used to specify that the procedure was performed on the right hand or fingers.
12. Modifier XS - Separate Structure: Used 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 coding guidelines and payer-specific policies for the most accurate and up-to-date information.
The CPT code 26445 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of payment rates for services covered by Medicare, including CPT code 26445. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and reimbursement policies for this code. Therefore, healthcare providers should consult their respective MAC for any regional variations or specific guidelines related to the reimbursement of CPT code 26445.
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