CPT code 27258 is used to describe the procedure for treating a hip dislocation through surgical intervention.
CPT code 27258 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 when a patient has suffered a dislocation due to trauma or injury, and it aims to restore normal function and alleviate pain in the hip area.
When billing for CPT code 27258, which pertains to the treatment of 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 surgical session, indicating that this is not the primary procedure.
3. Modifier 52 - Reduced Services: This modifier can be used if the service provided is less than what is typically required for the procedure.
4. Modifier 53 - Discontinued Procedure: If the procedure was started but had to be discontinued due to extenuating circumstances, this modifier should be applied.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the procedure is repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated by a different physician on the same day.
7. Modifier 78 - Return to the Operating Room for a Related Procedure: This modifier is applicable if the patient returns 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 of the original procedure.
9. Modifier 90 - Reference (Outside) Laboratory: If laboratory tests are sent to an outside lab for analysis related to the procedure, this modifier may be appropriate.
10. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when a laboratory test is repeated on the same day for the same patient.
It is essential to select the appropriate modifier based on the specific circumstances surrounding the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 27258 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the allowable payment amounts for various services covered by Medicare. Additionally, the reimbursement for CPT code 27258 may vary depending on the region and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) responsible for that area. It is essential for healthcare providers to consult the MPFS and their respective MAC to determine the exact reimbursement details and any additional requirements for CPT code 27258.
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