CPT code 27350 is the code used for the surgical removal of the kneecap, detailing the specific procedure for billing and documentation purposes.
CPT code 27350 is the code used for the surgical procedure involving the removal of the kneecap, also known as the patella. This procedure may be performed due to various conditions such as fractures, severe arthritis, or other knee-related issues that necessitate the complete removal of the kneecap to alleviate pain or restore function.
When billing for the CPT code 27350 (Removal of kneecap), 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 applicable if the removal of the kneecap is performed in conjunction with other surgical procedures 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 should be used if the procedure is part of a staged surgical approach or if it is a subsequent procedure related to a previous surgery.
4. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is appropriate if a return to the operating room is necessary due to complications or issues arising from the initial procedure.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: Use this modifier if a different procedure is performed during the postoperative period that is unrelated to the initial surgery.
6. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required, justifying additional reimbursement.
7. Modifier 26 - Professional Component: If the procedure is billed separately for the professional component (e.g., interpretation of imaging), this modifier should be applied.
8. Modifier TC - Technical Component: This modifier is used when billing for the technical component of the procedure separately, such as the facility or equipment used.
9. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: If applicable, this modifier can be used when the procedure involves repeat tests or evaluations.
It is essential to review the specific circumstances of the procedure and consult payer guidelines to determine the appropriate modifiers to use for accurate billing and reimbursement.
The CPT code 27350 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 for various CPT codes, including 27350. Additionally, MACs, which are responsible for processing Medicare claims, may have specific guidelines or requirements that could affect reimbursement.
Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 27350.
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 27350, you can ensure that every dollar is accounted for. Schedule a demo today to see how RevFind can help you maximize your reimbursements and streamline your financial processes.
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