CPT code 27357 is used for the surgical removal of a lesion from the femur, often involving a graft procedure.
CPT code 27357 is used to describe the surgical procedure for the removal of a lesion from the femur, which is the thigh bone. This code specifically indicates that a graft may also be involved in the procedure, either to repair the area after the lesion has been excised or to support the surrounding bone structure. This code is relevant for healthcare providers when documenting and billing for surgical interventions related to femoral lesions.
When billing for the CPT code 27357, which pertains to the removal of a femur lesion or graft, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used, along with the reasons for their application:
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 was distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side
Indicates that the procedure was performed on the left side of the body.
5. Modifier RT - Right Side
Indicates that the procedure was performed on the right side of the body.
6. Modifier 22 - Increased Procedural Services
Used when the procedure performed is significantly more complex or requires more time than typically required.
7. Modifier 26 - Professional Component
Indicates that only the professional component of a service is being billed, separating it from the technical component.
8. Modifier TC - Technical Component
Used when billing for the technical component of a service, separating it from the professional component.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room
Indicates that a patient required an unplanned return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Used when a procedure is performed that is unrelated to the original procedure during the postoperative period.
These modifiers help provide additional context for the services rendered and ensure accurate billing and reimbursement for the healthcare provider.
The CPT code 27357 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 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, it is advisable to consult the MPFS and the relevant MAC for precise information regarding the reimbursement of CPT code 27357.
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