CPT code 27400 is for the surgical revision of thigh muscles or tendons, detailing a specific procedure in healthcare billing and documentation.
CPT code 27400 is used to describe a surgical procedure that involves the revision of thigh muscles or tendons. This procedure typically aims to correct issues such as tears, injuries, or deformities in the muscles or tendons located in the thigh area, ensuring proper function and alignment.
When billing for the CPT code 27400, which pertains to revising thigh muscles or 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 thighs.
2. Modifier 51 - Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional
Used when the procedure is a staged procedure or a procedure that is related to a previous procedure performed by the same provider.
4. Modifier 59 - Distinct Procedural Service
Indicates that the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
Used when the same procedure is repeated by the same provider on the same day.
6. 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
Indicates that a return to the operating room was necessary due to complications or issues arising from the initial procedure.
7. 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.
8. Modifier RT - Right Side
Indicates that the procedure was performed on the right thigh.
9. Modifier LT - Left Side
Indicates that the procedure was performed on the left thigh.
10. Modifier 22 - Increased Procedural Services
Used when the procedure required significantly more work than typically required.
It is essential for healthcare providers to select the appropriate modifiers based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 27400 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of services covered by Medicare, including the reimbursement rates for each CPT code. Additionally, MACs may have specific guidelines or requirements for reimbursement, so it is crucial to consult with your local MAC to ensure compliance and proper billing practices.
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 CPT code 27400 and ensure you are receiving the correct reimbursements. Schedule a demo today to see how RevFind can optimize your revenue recovery process.
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
