CPT code 27000 is a medical code used to describe the procedure of making an incision in the hip tendon for treatment purposes.
CPT code 27000 is the procedure for making an incision in the hip tendon. This code is used to describe a surgical intervention aimed at accessing and potentially repairing or treating issues related to the tendons around the hip joint. It is typically utilized in cases where there is a need to address tendon injuries, inflammation, or other conditions affecting hip mobility and function.
When billing for the CPT code 27000 (Incision of hip tendon), several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used, along with the reasons for their application:
1. Modifier 50 - Bilateral Procedure
Used when the procedure is performed on both hips.
2. Modifier 51 - Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional
Used when the procedure is part of a staged or planned series of procedures.
4. Modifier 59 - Distinct Procedural Service
Indicates that the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
Used when the same procedure is performed again by the same provider.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
Indicates a return to the operating room for a related procedure due to complications.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
Used when a procedure is performed that is unrelated to the original procedure during the postoperative period.
8. Modifier 22 - Increased Procedural Services
Indicates that the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
Used when an evaluation and management service is provided that is unrelated to the procedure performed.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date
Indicates that multiple evaluation and management services were 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.
The CPT code 27000 is reimbursed by Medicare, but it is essential to verify the specific reimbursement rate and coverage details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment 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 27000.
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