CPT code 26567 is used to describe the procedure for correcting a finger deformity, ensuring accurate billing and documentation in healthcare.
CPT code 26567 is used to describe a surgical procedure that corrects a deformity of the finger. This code specifically pertains to the surgical intervention aimed at restoring the normal structure and function of the finger, which may involve realigning bones, repairing tendons, or addressing other anatomical issues. It is typically utilized in cases where a patient has a significant deformity that affects their ability to use the finger effectively.
When billing for CPT code 26567, which pertains to the correction of a finger deformity, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used:
1. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both hands.
2. Modifier 51 - Multiple Procedures: This modifier should be applied if multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is performed on a different site or is distinct from other services provided on the same day.
4. Modifier RT - Right Side: Use this modifier to indicate that the procedure was performed on the right hand.
5. Modifier LT - Left Side: This modifier is used to indicate that the procedure was performed on the left hand.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier should be used if the same procedure is performed again by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is applicable if the same procedure is performed again by a different physician on the same day.
8. Modifier 22 - Increased Procedural Services: This modifier can be used if the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: This modifier is relevant if an unrelated service is provided during the postoperative period of the procedure.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier may be used if multiple evaluation and management services are provided on the same day.
It is essential to evaluate the specific circumstances of the procedure to determine which modifiers are appropriate for accurate billing and compliance.
CPT code 26567 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).
The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. Additionally, the reimbursement for CPT code 26567 may vary depending on the local policies of the Medicare Administrative Contractor (MAC) that services your geographic region.
It is essential to consult the MPFS and your local MAC guidelines to determine the exact reimbursement rate and any additional requirements or limitations that may apply.
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. For instance, with CPT code 26567, RevFind identifies discrepancies that could impact your bottom line. Schedule a demo today to see how our solution can help you recover lost revenue and ensure accurate payments.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
