CPT code 27267 is used to describe the surgical treatment of a fracture in the thigh bone, specifically for closed treatment.
CPT code 27267 is used to describe the surgical procedure for the treatment of a fracture in the femur (thigh bone) that requires a closed treatment with or without manipulation. This code indicates that the healthcare provider has performed a procedure to stabilize the fracture without making an incision, which is essential for proper healing and recovery.
When billing for CPT code 27267, which pertains to a closed treatment of a thigh fracture, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used with this code, along with the reasons for their use:
1. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both thighs.
2. Modifier 51 - Multiple Procedures: This modifier should be applied 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 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier should be 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 During the Postoperative Period: This modifier is applicable if a different procedure is performed by the same physician during the postoperative period of the original procedure.
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 During a Postoperative Period: This modifier is appropriate if an unrelated evaluation and management service is provided during the postoperative period.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier may be used if multiple outpatient evaluation and management encounters occur on the same date.
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.
The CPT code 27267 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides detailed information on the reimbursement rates and guidelines for various CPT codes, including 27267. Additionally, MACs may have specific local coverage determinations (LCDs) that could affect the reimbursement process.
Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 27267.
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