CPT code 27254 is used to describe the treatment of a hip dislocation through surgical intervention.
CPT code 27254 is used to describe the surgical procedure for treating a hip dislocation. This code specifically refers to the closed reduction of a dislocated hip, which involves manipulating the hip joint back into its proper position without making an incision. This procedure is typically performed in an emergency setting to alleviate pain and restore function to the hip joint.
When billing for CPT code 27254, which pertains to the treatment of a hip dislocation, 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 during the same session.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if multiple procedures are performed during the same session, including the treatment of the hip dislocation.
3. Modifier 58 - Staged or Related Procedure: This modifier should be used if the treatment is part of a staged procedure or if it is a subsequent procedure related to the initial treatment.
4. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is appropriate if the procedure is repeated by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating Room: This modifier is used if the patient requires an unplanned return to the operating room for a related procedure within the global period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is applicable if a procedure unrelated to the original procedure is performed by the same physician during the global period.
8. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician: This modifier is relevant if an unrelated evaluation and management service is provided by the same physician during the global period.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is used when a patient has multiple encounters on the same date of service.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services rendered.
The CPT code 27254 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, it is advisable to consult with your local Medicare Administrative Contractor (MAC) to confirm any regional variations or specific billing guidelines that may apply to CPT code 27254. Each MAC may have unique requirements or updates that could impact reimbursement.
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 27254, 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.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
