CPT code 27187 is a medical billing code used to describe the procedure of reinforcing hip bones in healthcare settings.
CPT code 27187 is used to describe a surgical procedure that involves the reinforcement of the hip bones. This typically includes techniques to stabilize or support the hip joint, often following a fracture or in cases of severe joint instability. The procedure aims to enhance the structural integrity of the hip, promoting better function and reducing the risk of further injury.
When billing for the CPT code 27187, several modifiers 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 hips.
2. Modifier 51 - Multiple Procedures: This modifier should be applied if the procedure is performed in conjunction with other procedures on the same day.
3. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is performed separately from other procedures that may be reported on the same day.
4. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left hip.
5. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right hip.
6. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
7. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the procedure is repeated by the same physician on the same day.
8. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated by a different physician on the same day.
9. Modifier 92 - Alternative Laboratory Platform Testing: This modifier may be used if the procedure involves alternative testing methods that are not typically used.
10. Modifier KX - Requirements Met: This modifier indicates that specific requirements have been met for coverage of the procedure.
It is essential to select the appropriate modifier(s) based on the specific circumstances surrounding the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 27187 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding payment rates.
Additionally, reimbursement for CPT code 27187 may vary depending on the region, as Medicare Administrative Contractors (MACs) are responsible for processing claims and determining coverage specifics within their jurisdictions. Therefore, healthcare providers should consult their local MAC for precise information on reimbursement rates and any potential regional variations.
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 27187, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
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