CPT code 27282 is a medical billing code used for arthrodesis of the symphysis pubis, a surgical procedure to fuse the pelvic joint.
CPT code 27282 is used to describe a surgical procedure known as arthrodesis of the symphysis pubis. This procedure involves the fusion of the pubic symphysis, which is the joint located between the left and right pubic bones in the pelvis. The goal of this surgery is to alleviate pain and stabilize the pelvic region, often due to conditions such as instability or arthritis. By fusing the joint, the procedure aims to restore function and improve the patient's quality of life.
When billing for the CPT code 27282 (Arthrodesis symphysis pubis), 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 sides of the body.
2. Modifier 51 - Multiple Procedures: This modifier is applicable when multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional: Use this modifier if the procedure is part of a staged treatment plan.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is appropriate if the procedure is repeated by the same provider.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier if a related procedure is performed due to complications from the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier is applicable if a procedure unrelated to the initial procedure is performed during the postoperative period.
8. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required.
9. Modifier 27 - Multiple Encounters on the Same Date: This modifier is used when a patient has multiple encounters on the same date of service.
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 27282 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have specific guidelines and rates for different localities. Therefore, it is advisable to consult the MPFS and the relevant MAC for precise information regarding the reimbursement of CPT code 27282.
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