CPT code 27066 is used for the surgical removal of deep hip bone lesions, helping healthcare providers bill for this specific procedure.
CPT code 27066 is used to describe the surgical procedure for the removal of a deep bone lesion from the hip area. This code specifically indicates that the procedure involves excising or taking out a bone growth or abnormality that is located deep within the hip, which may be necessary for diagnostic or therapeutic reasons.
When billing for the CPT code 27066, 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 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 26 - Professional Component: This modifier is used when billing for the professional component of a service that has both a professional and technical component.
7. Modifier TC - Technical Component: This modifier is used when billing for the technical component of a service that has both a professional and technical component.
8. Modifier 22 - Increased Procedural Services: This modifier is used when the procedure performed is significantly more complex or requires more time than typically required.
9. Modifier 78 - Return to the Operating Room for a Related Procedure: This modifier is used when a patient returns to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
Each of these modifiers serves a specific purpose and should be used in accordance with the circumstances surrounding the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 27066 is subject to reimbursement by Medicare, but its eligibility for payment depends on various factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) for your region.
To determine if CPT code 27066 is reimbursed, you should first consult the MPFS to see if the code is listed and what the associated reimbursement rate is. Additionally, it's crucial to review the local coverage determinations (LCDs) and national coverage determinations (NCDs) provided by your MAC, as these documents outline the specific conditions and criteria under which Medicare will reimburse for this code.
Always ensure that the service meets the medical necessity requirements and documentation standards as specified by Medicare.
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 specific codes like 27066, ensuring you capture every dollar owed. Schedule a demo today to see how our solution can streamline your revenue recovery process.
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