CPT code 26450 is for the surgical procedure involving the incision of a tendon in the palm to treat conditions like trigger finger or tendon injuries.
CPT code 26450 is used to describe a surgical procedure involving the incision of a tendon in the palm. This code is typically utilized when a healthcare provider needs to make an incision to access or treat a tendon in the palm area, often to relieve conditions such as tendonitis or to repair tendon injuries.
For CPT code 26450 (Incision of palm tendon), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly greater effort than typically required. Documentation must support the substantial additional work.
2. Modifier 50 - Bilateral Procedure: If the incision of the palm tendon is performed on both hands during the same surgical session, this modifier should be used.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier indicates that the incision of the palm tendon is one of several procedures.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the physician's discretion, this modifier should be applied.
5. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the incision of the palm tendon was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the incision of the palm tendon procedure on the same day, this modifier should be used.
7. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the incision of the palm tendon procedure on the same day, this modifier is applicable.
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 needs to return 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 the incision of the palm tendon is performed during the postoperative period of another procedure but is unrelated, this modifier should be used.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier should be applied.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required for the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): If a qualified resident surgeon is not available and an assistant surgeon is required, this modifier should be used.
13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when a non-physician provider assists in the surgery.
Each modifier serves a specific purpose and should be used in accordance with the documentation and circumstances surrounding the procedure. Proper use of modifiers ensures accurate billing and reimbursement.
CPT code 26450 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services covered by Medicare, and it is updated annually to reflect changes in policy and payment rates. Additionally, reimbursement for CPT code 26450 may vary depending on the region, as Medicare Administrative Contractors (MACs) have the authority to make local coverage determinations. Therefore, it is advisable to consult the relevant MAC for your region to confirm the specific reimbursement criteria and rates for CPT code 26450.
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