CPT code 27275 is for the manipulation of the hip joint, a procedure to restore proper function and alignment.
CPT code 27275 is for the manipulation of the hip joint. This procedure involves the manual adjustment of the hip joint to restore its normal function and range of motion. It is typically performed to treat conditions such as dislocations or to alleviate pain and stiffness in the hip area.
When billing for CPT code 27275 (Manipulation of hip joint), 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 manipulation is performed on both hips during the same session.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if the manipulation is performed in conjunction with other surgical procedures on the same day.
3. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the manipulation is repeated on the same hip joint by the same physician on the same day.
4. Modifier 77 - Repeat Procedure by Another Physician: This modifier is appropriate if the manipulation is performed again on the same hip joint by a different physician on the same day.
5. Modifier 22 - Increased Procedural Services: If the manipulation required significantly more effort or time than usual, this modifier can be used to indicate that additional services were provided.
6. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: This modifier is relevant if an evaluation and management service is provided during the postoperative period that is unrelated to the manipulation.
7. Modifier 59 - Distinct Procedural Service: This modifier should be used if the manipulation is performed in a distinct session or on a different site that is not considered part of the primary procedure.
8. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services: This modifier can be used if the manipulation is performed by a non-physician practitioner.
Each of these modifiers serves to provide additional context for the procedure being billed, ensuring accurate reimbursement and compliance with payer requirements.
CPT code 27275 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered by Medicare, including CPT code 27275. To determine the exact reimbursement rate for this code, healthcare providers should refer to the MPFS, which is updated annually.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing claims and determining coverage specifics for CPT code 27275. MACs may have local coverage determinations (LCDs) that provide further guidance on the conditions under which this code is reimbursed. Therefore, it is essential for healthcare providers to consult both the MPFS and their respective MACs to ensure accurate billing and reimbursement for CPT code 27275.
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 27275, you can ensure that every dollar is accounted for. Schedule a demo today to see how RevFind can help you maximize your reimbursements and improve your financial performance.
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