CPT code 27244 is used to describe the treatment of a thigh fracture through surgical procedures.
CPT code 27244 is used to describe the surgical procedure for the treatment of a fracture in the femur, or thigh bone. This code specifically refers to the open treatment of a femoral fracture, which may involve the use of internal fixation devices such as plates or screws to stabilize the bone and promote healing. This procedure is typically performed when the fracture is complex or cannot be adequately treated with non-surgical methods.
When billing for CPT code 27244, which pertains to the treatment of a thigh 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 thighs.
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: Use this modifier if the procedure is part of a staged treatment plan or if it is a subsequent procedure related to the initial treatment.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier should be used if the same procedure is repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the same procedure is performed by a different physician on the same day.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is applicable if the patient requires an unplanned return to the operating room for a related procedure within the global period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a different procedure is performed by the same physician during the postoperative period that is unrelated to the original procedure.
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 laboratory test is repeated on the same day for the same patient.
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.
The CPT code 27244 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for this CPT code. It is essential for healthcare providers to consult both the MPFS and their respective MAC to ensure compliance with Medicare's billing and reimbursement guidelines for CPT code 27244.
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 RevFind, you can identify discrepancies related to CPT code 27244. Schedule a demo today to see how our solution can help you maximize your reimbursements and streamline your financial processes.
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