CPT code 27047 is used for excising a hip or pelvis lesion smaller than 3 cm, helping to standardize medical billing and documentation.
CPT code 27047 is used to describe the excision of a lesion from the hip or pelvis that is less than 3 centimeters in size. This procedure involves the surgical removal of the lesion, which may be necessary for diagnostic purposes or to treat a condition affecting the hip or pelvic area.
When billing for CPT code 27047, there are several modifiers that 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: This modifier is used when the procedure is performed on both sides of the body.
2. Modifier 51 - Multiple Procedures: This modifier indicates that multiple procedures were performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side: This modifier specifies that the procedure was performed on the left side of the body.
5. Modifier RT - Right Side: This modifier specifies that the procedure was performed on the right side of the body.
6. Modifier 22 - Increased Procedural Services: This modifier is used when the procedure performed is more complex than usual, warranting additional reimbursement.
7. Modifier 76 - Repeat Procedure by Same Physician: This modifier indicates that a procedure was repeated by the same physician on the same day.
8. Modifier 77 - Repeat Procedure by Another Physician: This modifier indicates that a procedure was repeated by a different physician on the same day.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is used when a patient requires an unplanned return to the operating room for a related procedure within the global period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
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 27047 is reimbursed by Medicare, but it is essential to verify its 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, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and guidelines that affect coverage. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 27047.
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. With RevFind, you can identify discrepancies for CPT code 27047 and ensure you are receiving the payments you deserve. Schedule a demo today to see how our solution can help you optimize your revenue.
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