CPT code 27337 is a medical billing code used to describe the excision of a thigh or knee lesion larger than 3 cm.
CPT code 27337 is used to describe a surgical procedure involving the excision of a lesion located in the thigh or knee area, specifically when the lesion is larger than 3 centimeters. This code indicates that the procedure is more complex due to the size of the lesion, and it typically involves removing the lesion along with some surrounding tissue to ensure complete excision.
When billing for the CPT code 27337, which pertains to excision of a thigh or knee lesion greater than 3 cm, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used with this code, along with the reasons for their use:
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 59 - Distinct Procedural Service
Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician
Indicates that a procedure was repeated by the same physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room
Used when a patient requires a return to the operating room for a related procedure within the global period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
7. Modifier LT - Left Side
Used to specify that the procedure was performed on the left side of the body.
8. Modifier RT - Right Side
Used to specify that the procedure was performed on the right side of the body.
9. Modifier 22 - Increased Procedural Services
Indicates that the work required to provide a service was substantially greater than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date
Used when a patient has multiple encounters on the same date of service.
It is essential for healthcare providers to carefully evaluate the specific circumstances of the procedure to determine the appropriate modifiers to use, ensuring accurate billing and compliance with payer requirements.
The CPT code 27337 is reimbursed by Medicare, but it is essential to verify its specific reimbursement status through the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered under Medicare Part B. Additionally, reimbursement can vary based on the local policies set by the Medicare Administrative Contractor (MAC) for your region. Therefore, it is advisable to consult the MPFS and your regional MAC to confirm the exact reimbursement details for CPT code 27337.
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 RevFind, you can identify discrepancies for specific CPT code 27337, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how our solution can streamline your revenue recovery process.
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