CPT code 27295 is for the surgical procedure involving the amputation of a leg at the hip joint, used for billing and documentation in healthcare.
CPT code 27295 is the designation for the surgical procedure involving the amputation of the leg at the hip joint. This code is used to indicate that the entire leg, including the thigh and lower limb, has been surgically removed at the hip level. It is typically utilized in cases where severe trauma, disease, or other medical conditions necessitate the removal of the leg to preserve the patient's overall health and well-being.
When billing for CPT code 27295 (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 -51: Multiple Procedures
- Indicates that multiple procedures were performed during the same session.
3. Modifier -58: Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional
- Used when a subsequent procedure is planned or anticipated during the postoperative period.
4. Modifier -78: Return to the Operating Room for a Related Procedure During the Postoperative Period
- Indicates that a related procedure was performed during the postoperative period of the initial surgery.
5. Modifier -79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Used when a procedure unrelated to the original surgery is performed during the postoperative period.
6. Modifier -RT: Right Side
- Indicates that the procedure was performed on the right side of the body.
7. Modifier -LT: Left Side
- Indicates that the procedure was performed on the left side of the body.
8. Modifier -22: Increased Procedural Services
- Used when the procedure performed is significantly more complex or requires more time than typically required.
9. Modifier -26: Professional Component
- Indicates that only the professional component of a service is being billed.
10. Modifier -TC: Technical Component
- Indicates that only the technical component of a service is being billed.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 27295 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 27295. Additionally, MACs may have localized policies or additional requirements that could affect reimbursement. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and compliant billing for CPT code 27295.
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