CPT code 26587 is used to describe the surgical procedure for reconstructing an extra finger.
CPT code 26587 is used to describe the surgical procedure for reconstructing an extra finger. This code specifically pertains to the surgical techniques employed to remove or modify the additional digit, ensuring proper function and appearance of the hand. It is typically utilized in cases of polydactyly, where a patient has more than five fingers on one hand.
When billing for the CPT code 26587 (Reconstruct extra finger), several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. -50: Bilateral Procedure
Used when the procedure is performed on both hands.
2. -51: Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. -59: Distinct Procedural Service
Used to indicate that the procedure is distinct or independent from other services performed on the same day.
4. -76: Repeat Procedure by Same Physician
Indicates that the same procedure was performed again by the same physician on the same day.
5. -78: Unplanned Return to the Operating/Procedure Room
Used when a patient requires a return to the operating room for a related procedure within the global period.
6. -79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Indicates that a procedure unrelated to the original procedure was performed during the postoperative period.
7. -RT: Right Side
Used to specify that the procedure was performed on the right hand.
8. -LT: Left Side
Used to specify that the procedure was performed on the left hand.
9. -22: Increased Procedural Services
Indicates that the service provided was significantly greater than what is typically required for the procedure.
10. -27: Multiple Outpatient Hospital E/M Encounters on the Same Date
Used when multiple evaluation and management services are provided on the same day.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 26587 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, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may apply to CPT code 26587. Each MAC may have unique guidelines and policies that could impact reimbursement.
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