CPT code 27035 is a medical billing code for the denervation procedure of the hip joint, used to describe specific healthcare services.
CPT code 27035 is the code used to describe the procedure of denervation of the hip joint. This procedure involves the surgical interruption of nerve pathways to alleviate pain in the hip area. It is typically performed when conservative treatments have failed, and the goal is to reduce discomfort and improve the patient's quality of life by targeting the specific nerves responsible for transmitting pain signals from the hip joint.
When billing for the CPT code 27035 (Denervation of hip joint), 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 hips.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if the denervation is performed in conjunction with other surgical procedures on the same day.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used when the procedure is performed separately and is not considered part of another procedure.
4. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left hip joint.
5. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right hip joint.
6. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
7. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period: This modifier is applicable if an evaluation and management service is provided during the postoperative period that is unrelated to the surgery.
8. Modifier 78 - Return to the Operating Room for a Related Procedure During the Postoperative Period: Use this modifier if a related procedure is performed during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier is applicable if an unrelated procedure is performed during the postoperative period.
10. Modifier 33 - Preventive Services: This modifier may be used if the procedure is part of a preventive service.
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 27035 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 it is updated annually to reflect changes in policy and reimbursement rates.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for specific CPT codes. Therefore, while CPT code 27035 is generally reimbursed by Medicare, healthcare providers should consult the MPFS and their respective MAC for precise reimbursement information and any potential regional variations.
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