CPT code 27062 is used for the removal of a lesion or bursa from the femur, helping healthcare providers document and bill for this specific procedure.
CPT code 27062 is used to describe the surgical procedure for the removal of a lesion or bursa located in the femur, which is the thigh bone. This code indicates that the healthcare provider has performed an excision to eliminate abnormal tissue or fluid-filled sacs in that area, often to alleviate pain or improve function.
When billing for the CPT code 27062, 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: Use this modifier if the procedure is performed on both sides of the body.
2. Modifier 51 - Multiple Procedures: This modifier is applicable when multiple procedures are performed during the same session, indicating that the primary procedure is being billed along with additional procedures.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used when the procedure is distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side: Use this modifier to specify that the procedure was performed on the left side of the body.
5. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right side of the body.
6. Modifier 22 - Increased Procedural Services: This modifier can be used if the procedure required significantly more work than typically required, justifying additional reimbursement.
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 return to the operating room is necessary for a related procedure within 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 appropriate if a procedure unrelated to the original surgery is performed during the postoperative period.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier is used when multiple evaluation and management services are provided on the same day in an outpatient setting.
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 27062 is reimbursed by Medicare, but the reimbursement is subject to the guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates.
Additionally, the reimbursement for CPT code 27062 may vary depending on the specific Medicare Administrative Contractor (MAC) that processes claims in your region. Each MAC has the authority to interpret Medicare policies and may have local coverage determinations that affect the reimbursement process.
Therefore, it is essential to verify with your regional MAC to ensure compliance and accurate reimbursement for CPT code 27062.
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 27062, RevFind identifies discrepancies that could impact your bottom line. Schedule a demo today to see how our software can help you recover lost revenue and optimize your financial performance.
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