CPT code 27360 is for the partial removal of leg bone(s), detailing a specific surgical procedure in healthcare billing and documentation.
CPT code 27360 is for the partial removal of leg bone(s). This procedure involves surgically excising a portion of the bone in the leg, which may be necessary due to conditions such as fractures, tumors, or infections. The goal of this surgery is to alleviate pain, restore function, or prevent further complications related to the affected bone.
When billing for the CPT code 27360 (Partial removal leg bone(s)), 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 legs.
2. Modifier 51 - Multiple Procedures: This modifier should be applied if multiple procedures are performed 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 is appropriate if the procedure is a staged procedure or if it is related to a previous procedure performed by the same provider.
4. Modifier 59 - Distinct Procedural Service: Use this modifier when the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the procedure is repeated by the same physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure: This modifier should be used if an unplanned return to the operating room is necessary for a related procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is appropriate if a procedure unrelated to the original procedure is performed during the postoperative period.
8. Modifier LT - Left Side: Use this modifier to specify that the procedure was performed on the left leg.
9. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right leg.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required 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 compliance with payer requirements.
The CPT code 27360 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, reimbursement for CPT code 27360 may vary depending 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 current reimbursement status and any specific billing requirements for CPT code 27360.
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