CPT code 27391 is a medical billing code used for the incision of thigh tendons during surgical procedures.
CPT code 27391 is the procedure for making an incision in the tendons of the thigh. This code is used to describe surgical interventions that involve accessing and potentially repairing or releasing the tendons located in the thigh region. It is typically utilized in cases where there is a need to address tendon injuries, conditions, or abnormalities affecting the function of the thigh muscles.
When billing for the CPT code 27391 (Incision of thigh tendons), 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 or service was distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side
Used to specify that the procedure was performed on the left side of the body.
5. Modifier RT - Right Side
Used to specify that the procedure was performed on the right side of the body.
6. Modifier 22 - Increased Procedural Services
Indicates that the procedure was more complex than usual, warranting additional reimbursement.
7. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
Used when a patient requires an evaluation and management service unrelated to the original procedure during the postoperative period.
8. Modifier 78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Indicates that a patient returned to the operating room for a related procedure within the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
Used when a procedure is performed that is unrelated to the original procedure during the postoperative period.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date
Used when a patient has multiple outpatient encounters on the same date of service.
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 reimbursement of CPT code 27391 by Medicare depends on its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) for your region.
To determine if CPT code 27391 is reimbursed by Medicare, you should first consult the MPFS, which provides a comprehensive list of services covered and their respective reimbursement rates.
Additionally, each MAC may have specific local coverage determinations (LCDs) that could affect the reimbursement status of CPT code 27391.
Therefore, it is crucial to review both the MPFS and the relevant MAC guidelines to confirm if this particular CPT code is reimbursed by Medicare.
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. With RevFind, you can identify discrepancies for specific codes like 27391, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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