CPT CODES

CPT Code 26740

CPT code 26740 is used to describe the treatment of a finger fracture, detailing the specific procedure performed on the injured digit.

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What is CPT Code 26740

CPT code 26740 is used to describe the treatment of a fracture in a finger. This code specifically refers to the procedure of managing a fracture in one of the finger bones, which may involve methods such as immobilization, manipulation, or surgical intervention, depending on the severity and nature of the fracture. It is important for healthcare providers to use this code accurately to ensure proper billing and reimbursement for the services rendered in treating finger fractures.

Does CPT 26740 Need a Modifier?

When billing for CPT code 26740, which pertains to the treatment of a finger fracture, 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. 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 when multiple procedures are performed during the same session.

3. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is performed separately from other procedures on the same day, indicating that it is not part of a bundled service.

4. Modifier RT - Right Side: Use this modifier when the procedure is performed on the right hand.

5. Modifier LT - Left Side: This modifier is used when the procedure is performed on the left hand.

6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the procedure is repeated by the same physician on the same day.

7. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated by a different physician on the same day.

8. Modifier 22 - Increased Procedural Services: This modifier may 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 Encounters on the Same Date: This modifier is used when a patient has multiple encounters on the same day for different services.

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 26740 Medicare Reimbursement

The CPT code 26740 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 can be accessed through the Centers for Medicare & Medicaid Services (CMS) website.

Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have specific guidelines and rates for different localities. Therefore, it is advisable to consult the relevant MAC for precise information regarding the reimbursement of CPT code 26740 in your area.

Are You Being Underpaid for 26740 CPT Code?

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