CPT code 27307 is for the surgical incision of thigh tendons, used to describe a specific medical procedure in billing and documentation.
CPT code 27307 is for the surgical procedure involving the incision of tendons in the thigh. This code is used to describe the specific action of accessing and potentially repairing or releasing the tendons located in the thigh region, which may be necessary due to injury, tightness, or other conditions affecting mobility and function.
When billing for CPT code 27307 (Incision of thigh tendons), 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 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 or Service by the Same Physician or Other Qualified Health Care Professional: This modifier is appropriate if the procedure is part of a staged treatment plan.
4. Modifier 59 - Distinct Procedural Service: Use this modifier when the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the procedure is repeated by the same physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure: This modifier is used if the patient requires an unplanned return to the operating room for a related procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is appropriate if a different procedure is performed during the postoperative period of the initial procedure.
8. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right thigh.
9. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left thigh.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements.
The CPT code 27307 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 reimbursement rates.
Additionally, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 27307. The MACs play a pivotal role in processing Medicare claims and can provide detailed information on coverage policies and payment rates specific to your geographic area.
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 27307, you can ensure that every dollar earned is accounted for. Schedule a demo today to see how RevFind can help you identify and rectify underpayments effectively.
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