CPT code 26746 is used to describe the treatment of a finger fracture, detailing the specific procedure performed on the injured finger.
CPT code 26746 is used to describe the treatment of a fracture in the finger. This code specifically refers to the procedure of managing a fracture in each finger, which may involve techniques such as realignment, stabilization, or surgical intervention to ensure proper healing and function of the digit.
When billing for CPT code 26746, 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 or fingers.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if the treatment of the finger fracture is performed alongside other procedures during the same session.
3. Modifier 58 - Staged or Related Procedure or Service: This modifier should be used if the treatment is part of a staged procedure or if it is a subsequent procedure related to the initial treatment.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the procedure is repeated on the same finger by the same provider.
5. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated on the same finger by a different provider.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is relevant if the patient requires an unplanned return to the operating room for complications related to the initial treatment.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a different procedure unrelated to the original treatment is performed during the postoperative period.
8. Modifier 22 - Increased Procedural Services: This modifier may be used if the treatment of the finger fracture 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 appropriate if an evaluation and management service is provided that is unrelated to the surgical procedure during the postoperative period.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier can be used if the patient has multiple encounters on the same day for different issues, including the treatment of the finger fracture.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the treatment to ensure accurate billing and compliance with payer requirements.
The CPT code 26746 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates. Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may affect reimbursement for CPT code 26746.
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 26746, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
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