CPT code 27465 is a medical code used to describe the surgical procedure for shortening the thigh bone.
CPT code 27465 is the code used to describe the surgical procedure for shortening the thigh bone, also known as the femur. This procedure is typically performed to correct deformities, alleviate pain, or improve function in patients with conditions affecting the femur. It involves removing a section of the bone and then stabilizing the remaining ends to promote healing and restore proper alignment.
When billing for CPT code 27465, which pertains to the shortening of the thigh bone, 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 52 - Reduced Services
Used when the service provided is less than what is typically required for the procedure.
4. Modifier 53 - Discontinued Procedure
Applied when the procedure was started but had to be discontinued due to extenuating circumstances.
5. Modifier 59 - Distinct Procedural Service
Indicates that the procedure is distinct or independent from other services performed on the same day.
6. Modifier LT - Left Side
Used to specify that the procedure was performed on the left side of the body.
7. Modifier RT - Right Side
Used to specify that the procedure was performed on the right side of the body.
8. Modifier 76 - Repeat Procedure or Service by Same Physician
Indicates that a procedure or service was repeated by the same physician on the same day.
9. Modifier 77 - Repeat Procedure by Another Physician
Used when the same procedure is performed by a different physician on the same day.
10. 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.
11. 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 procedure associated with CPT code 27465.
CPT code 27465 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates. However, the final determination of reimbursement for CPT code 27465 may also depend on the policies of the Medicare Administrative Contractor (MAC) for your specific region. MACs are responsible for processing Medicare claims and can have localized policies that affect coverage and payment. Therefore, it is essential to consult both the MPFS and your regional MAC to confirm the reimbursement details for CPT code 27465.
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