CPT code 27477 is a surgical procedure used to stop leg growth, often performed to address limb length discrepancies or other growth-related issues.
CPT code 27477 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 when growth needs to be halted for medical reasons. This procedure may involve techniques such as epiphysiodesis, where the growth plate is surgically altered to prevent further growth in the affected leg.
When billing for the CPT code 27477, 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 when multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used to indicate that a 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 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is relevant if the patient requires a return to the operating room for a related procedure within the global period.
7. 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.
8. Modifier 22 - Increased Procedural Services: This modifier can be used if the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: This modifier is appropriate if an evaluation and management service is provided during the postoperative period that is unrelated to the surgery.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier is applicable if multiple evaluation and management encounters occur on the same day.
Each of these modifiers serves to provide additional context for the procedure performed and can help ensure accurate reimbursement and compliance with billing regulations.
CPT code 27477 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered by Medicare, including CPT code 27477. To determine the exact reimbursement amount, healthcare providers should refer to the MPFS, which is updated annually.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide region-specific information regarding coverage and payment rates for CPT code 27477. Providers should consult their respective MAC for detailed guidance on the reimbursement process and any local coverage determinations (LCDs) that may affect the payment for this code.
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 27477, ensuring you receive the full reimbursement you deserve. 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
