CPT code 27290 is a medical billing code for the amputation of a leg at the hip, used for accurate healthcare documentation and reimbursement.
CPT code 27290 is the code used to describe the surgical procedure of amputating the leg at the hip joint. This procedure involves the removal of the entire leg, including the thigh, at the point where it connects to the pelvis. It is typically performed in cases of severe trauma, infection, or other medical conditions that necessitate the removal of the limb to preserve the patient's health.
When billing for CPT code 27290 (Amputation of leg at hip), 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
- Used when the procedure is performed on both sides of the body.
2. Modifier -LT: Left Side
- Indicates that the procedure was performed on the left leg.
3. Modifier -RT: Right Side
- Indicates that the procedure was performed on the right leg.
4. Modifier -59: Distinct Procedural Service
- Used to indicate that the procedure is distinct or independent from other services performed on the same day.
5. Modifier -76: Repeat Procedure by Same Physician
- Indicates that the same procedure was performed more than once by the same physician on the same day.
6. Modifier -77: Repeat Procedure by Another Physician
- Used when the same procedure is performed by a different physician on the same day.
7. Modifier -E1: Upper Left Eyelid
- While not directly applicable to leg amputation, it is included for completeness as a modifier for specific anatomical locations.
8. Modifier -E2: Upper Right Eyelid
- Similar to E1, included for completeness.
9. Modifier -E3: Lower Left Eyelid
- Included for completeness.
10. Modifier -E4: Lower Right Eyelid
- Included for completeness.
It is essential to choose the appropriate modifier(s) based on the specifics of the procedure performed to ensure accurate billing and compliance with payer requirements.
The CPT code 27290 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 payment rates for services covered under Medicare Part B. Additionally, the reimbursement for CPT code 27290 may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region.
It is essential to consult the MPFS and your regional MAC guidelines to determine the exact reimbursement rate and any additional requirements or limitations that may apply.
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