CPT code 27475 is a surgical procedure used to stop leg growth, often performed to address limb length discrepancies in patients.
CPT code 27475 is a surgical procedure aimed at stopping the growth of the leg, typically performed in cases where there is a significant discrepancy in leg length or other growth-related issues. This procedure may involve techniques such as epiphysiodesis, where the growth plate is surgically altered to prevent further growth in the affected leg, thereby helping to achieve better alignment and function.
When billing for the CPT code 27475, 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 legs.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if multiple surgical procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used when the procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the procedure is repeated by the same physician on the same day.
5. 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.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a different procedure is performed by the same physician during the postoperative period of the initial procedure.
7. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left leg specifically.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right leg specifically.
9. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is applicable if the patient has multiple encounters on the same date of service.
Each of these modifiers serves to provide additional context to the procedure being billed, ensuring accurate reimbursement and compliance with payer requirements.
CPT code 27475 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable guidelines, healthcare providers should refer to the MPFS.
Additionally, it is essential to consult with the respective Medicare Administrative Contractor (MAC) for the region, as MACs may have localized policies or additional requirements that could impact reimbursement.
Always ensure that the service meets Medicare's medical necessity criteria and proper documentation is maintained to support the claim.
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