CPT code 27080 is for the surgical removal of the tailbone, a procedure often performed to alleviate pain or discomfort.
CPT code 27080 is the procedure code used for the surgical removal of the tailbone, also known as the coccyx. This procedure is typically performed to alleviate pain or discomfort caused by conditions such as coccydynia, which is inflammation or injury to the tailbone area. The code encompasses the surgical techniques involved in excising the coccyx, which may be indicated when conservative treatments have failed to provide relief.
When billing for the CPT code 27080, 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 appropriate when multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier indicates that 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 is applicable 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: Use this modifier if an unrelated service is provided during the postoperative period.
8. 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.
9. Modifier 78 - Return to the Operating Room for a Related Procedure During the Postoperative Period: This modifier is appropriate if a related procedure is performed in the operating room 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: Use this modifier if an unrelated procedure is performed 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 27080 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS).
The MPFS provides a comprehensive list of services covered by Medicare and the corresponding reimbursement rates. Additionally, the reimbursement for CPT code 27080 may vary depending on the local policies and determinations made by the Medicare Administrative Contractor (MAC) for your region.
It is essential to consult the MPFS and your regional MAC to understand the exact reimbursement details and any additional requirements that may apply.
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