CPT code 27328 is for excising a deep thigh or knee tumor that is less than 5 cm in size.
CPT code 27328 is used to describe a surgical procedure involving the excision of a tumor located in the thigh or knee area that is deep and measures less than 5 centimeters in size. This code indicates that the procedure is focused on removing the tumor while considering its depth and size, which are important factors in determining the complexity and approach of the surgery.
When billing for CPT code 27328, which pertains to excision of a thigh or knee tumor less than 5 cm deep, 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 the left and right thigh or knee.
2. Modifier 51 - Multiple Procedures: This modifier should be applied when multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the same procedure is performed more than once by the same physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is applicable if a patient requires a return to the operating room for complications related to the initial procedure.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if a different procedure is performed by the same physician during the postoperative period of the initial procedure.
7. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left side of the body.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right side of the body.
9. Modifier 22 - Increased Procedural Services: This modifier can be used if the procedure required significantly more work than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is used when a patient has multiple encounters on the same date of service.
Each of these modifiers serves a specific purpose and helps to provide additional context for the services rendered, ensuring accurate billing and reimbursement.
CPT code 27328 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, including the reimbursement rates for each CPT code. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement. Therefore, it is advisable to consult both the MPFS and your local MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 27328.
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. With the ability to identify discrepancies for specific codes like 27328, you can ensure your practice is receiving the full reimbursement it deserves. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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