CPT code 27075 is a medical billing code used to describe the surgical procedure for resecting a tumor in the hip.
CPT code 27075 is used to describe the surgical procedure for resecting a tumor located in the hip region. This code indicates that a healthcare provider has performed an operation to remove a tumor from the hip joint or surrounding tissues, which may involve excising both the tumor and any affected surrounding structures to ensure complete removal and minimize the risk of recurrence.
When billing for the CPT code 27075 (Resect hip tumor), 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 59 - Distinct Procedural Service
Used to indicate that the procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician
Applied when the same procedure is performed more than once by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician
Indicates that the same procedure was performed by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room
Used when a patient requires a return to the operating room for a related procedure within the global period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
8. Modifier LT - Left Side
Used to specify that the procedure was performed on the left hip.
9. Modifier RT - Right Side
Used to specify that the procedure was performed on the right hip.
10. Modifier 22 - Increased Procedural Services
Indicates that the procedure was more complex than usual, warranting additional reimbursement.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements.
CPT code 27075 is reimbursed by Medicare, but the reimbursement specifics can vary. To determine if this code is covered and the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare. Additionally, it's essential to consult with your local Medicare Administrative Contractor (MAC), as they administer Medicare claims and can provide region-specific guidance on coverage and reimbursement for CPT code 27075.
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