CPT code 27345 is for the removal of a knee cyst, detailing the specific procedure for accurate billing and documentation in healthcare.
CPT code 27345 is the procedure code used for the surgical removal of a cyst located in the knee area. This code specifically indicates that the cyst, which may be causing discomfort or other issues, has been excised through a surgical procedure. It is important for healthcare providers to use this code accurately to ensure proper billing and reimbursement for the services rendered.
When billing for the CPT code 27345 (Removal of knee cyst), 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 knees.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if the removal of the knee cyst is performed alongside other surgical procedures during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used when 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 applicable if the procedure is repeated on the same knee by the same physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the 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: This modifier is relevant if a different procedure is performed on the same knee by the same physician during the postoperative period.
7. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right knee.
8. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left knee.
9. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services: This modifier is used when the procedure is performed by a non-physician practitioner under the supervision of a physician.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure requires significantly more work than typically required.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and reimbursement.
The CPT code 27345 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, including the associated payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have specific guidelines and rates for different localities. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and up-to-date reimbursement information for CPT code 27345.
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