CPT code 27466 is a medical billing code for the surgical lengthening of the thigh bone, used for accurate healthcare billing and documentation.
CPT code 27466 is a procedure that involves the surgical lengthening of the thigh bone (femur). This operation is typically performed to correct deformities, improve limb function, or address discrepancies in leg length. The procedure may involve techniques such as osteotomy and the use of external fixation devices to gradually lengthen the bone over time.
When billing for CPT code 27466, which pertains to the lengthening of the thigh bone, there are several modifiers that may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used:
1. -50: Bilateral Procedure
Used when the procedure is performed on both sides of the body.
2. -51: Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. -58: Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
Used when a subsequent procedure is planned or anticipated during the postoperative period of the initial procedure.
4. -59: Distinct Procedural Service
Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. -76: Repeat Procedure by Same Physician
Used when the same procedure is repeated by the same physician on the same day.
6. -78: Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
Indicates an unplanned return to the operating room for a related procedure.
7. -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.
8. -RT: Right Side
Indicates that the procedure was performed on the right side of the body.
9. -LT: Left Side
Indicates that the procedure was performed on the left side of the body.
10. -22: Increased Procedural Services
Used when the complexity of the procedure is significantly greater than typically required.
Each of these modifiers serves a specific purpose in clarifying the nature of the procedure performed and ensuring accurate billing and reimbursement. It is essential to select the appropriate modifier(s) based on the clinical scenario to avoid claim denials and ensure compliance with payer requirements.
The CPT code 27466 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 respective reimbursement rates.
Additionally, it is crucial 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 27466. Each MAC may have unique policies that could influence the reimbursement process, so staying informed through both the MPFS and your MAC is recommended for accurate and up-to-date information.
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