CPT CODES

CPT Code 27479

CPT code 27479 is a surgical procedure used to stop leg growth, often performed to address limb length discrepancies or other growth-related issues.

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What is CPT Code 27479

CPT code 27479 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, ensuring better alignment and function of the legs.

Does CPT 27479 Need a Modifier?

When billing for the CPT code 27479, there are several modifiers that 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 applicable if multiple surgical procedures are performed during the same session.

3. Modifier 59 - Distinct Procedural Service: Use this modifier when the procedure is performed separately from other services on the same day, indicating that it is not part of a bundled service.

4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the procedure is repeated by the same physician on the same day.

5. Modifier 77 - Repeat Procedure by Another Physician: This modifier applies if the procedure is repeated by a different physician on the same day.

6. 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.

7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is applicable if a different procedure is performed by the same physician during the postoperative period of the initial procedure.

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 used if an evaluation and management service is provided during the postoperative period that is unrelated to the original procedure.

10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier is applicable if multiple evaluation and management services are provided on the same day in an outpatient setting.

It is essential to select the appropriate modifier(s) based on the specific circumstances surrounding the procedure to ensure accurate billing and compliance with payer requirements.

CPT Code 27479 Medicare Reimbursement

The CPT code 27479 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment amounts. Additionally, reimbursement for CPT code 27479 may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region. Therefore, it is advisable to consult the MPFS and your regional MAC to confirm the reimbursement details for CPT code 27479.

Are You Being Underpaid for 27479 CPT Code?

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