CPT code 27390 is a medical billing code used for the incision of a thigh tendon, helping healthcare providers document and bill for this procedure.
CPT code 27390 is the procedure for the incision of a tendon in the thigh. This code is used when a healthcare provider performs a surgical incision to access and treat issues related to the thigh tendon, which may involve repairing or releasing the tendon to alleviate pain or restore function.
When billing for the CPT code 27390 (Incision of thigh tendon), 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 thighs.
2. Modifier 51 - Multiple Procedures: This modifier should be applied when multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure: This modifier is appropriate if the procedure is a staged or related procedure that is performed during the postoperative period of another procedure.
4. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient requires a return to the operating room for a related procedure within the global period.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier is applicable if a different procedure is performed during the postoperative period that is unrelated to the original procedure.
6. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
7. Modifier 26 - Professional Component: If the service is split between a professional and technical component, this modifier should be used to indicate the professional component.
8. Modifier TC - Technical Component: Similar to Modifier 26, this modifier indicates the technical component of the service if applicable.
9. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: If a repeat test is performed on the same day, this modifier may be used.
10. Modifier 99 - Multiple Modifiers: This modifier is used when more than one modifier is applicable to the procedure.
It is essential to review the specific circumstances of the procedure and the payer guidelines to determine the appropriate modifiers to use for accurate billing and reimbursement.
The CPT code 27390 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 reimbursement rates. Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 27390.
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, including specific codes like 27390. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and optimize your revenue.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
