CPT CODES

CPT Code 26535

CPT code 26535 is used to describe the procedure for revising a finger joint, detailing the specific surgical intervention performed.

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What is CPT Code 26535

CPT code 26535 is used to describe a surgical procedure that involves the revision of a finger joint. This typically means that the procedure is performed to correct or improve the function of a previously operated or damaged finger joint, addressing issues such as pain, instability, or limited range of motion. The revision may involve repairing or reconstructing the joint to restore its normal function.

Does CPT 26535 Need a Modifier?

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CPT Code 26535 Medicare Reimbursement

The CPT code 26535 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 by Medicare. Additionally, reimbursement can vary based on the policies of the Medicare Administrative Contractor (MAC) that services your geographic region. Each MAC may have specific guidelines and local coverage determinations (LCDs) that affect whether and how a particular CPT code is reimbursed. Therefore, it is advisable to consult both the MPFS and your regional MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 26535.

Are You Being Underpaid for 26535 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. With RevFind, you can identify discrepancies for specific codes like 26535, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can streamline your revenue recovery process.

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