CPT code 27193 is used to describe the surgical treatment of a pelvic ring fracture in healthcare billing and documentation.
CPT code 27193 is used to describe the surgical procedure for treating a pelvic ring fracture. This code specifically refers to the surgical intervention aimed at stabilizing and repairing the fracture in the pelvic ring, which is crucial for restoring the structural integrity of the pelvis and facilitating proper healing. The procedure may involve the use of hardware or fixation devices to ensure that the bones are properly aligned and secured during the recovery process.
When billing for CPT code 27193, which pertains to the treatment of a pelvic ring fracture, 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 sides of the body.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure: This modifier should be used if the procedure is a staged or related procedure that is performed during the postoperative period.
4. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure is repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician: This modifier is applicable if the same procedure is repeated by a different physician on the same day.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient requires an unplanned return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a procedure unrelated to the original procedure is performed during the postoperative period.
9. Modifier 90 - Reference (Outside) Laboratory: This modifier is applicable if the procedure involves the use of an outside laboratory for diagnostic testing.
10. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Use this modifier if a clinical diagnostic laboratory test is repeated on the same day.
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 27193 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and consult with your regional Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of services covered by Medicare, including their respective reimbursement rates. Additionally, MACs play a crucial role in determining local coverage decisions and can offer guidance on any specific documentation or billing requirements for CPT code 27193.
Therefore, while Medicare does reimburse this code, always ensure compliance with both MPFS guidelines and MAC directives to secure appropriate reimbursement.
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