CPT code 27502 is used for billing the treatment of a thigh fracture in healthcare services.
CPT code 27502 is used to describe the treatment of a fracture in the thigh bone (femur). This code specifically refers to the surgical procedure involved in stabilizing and repairing the fracture, which may include methods such as internal fixation or external fixation, depending on the nature and severity of the injury. It is essential for healthcare providers to use this code accurately to ensure proper billing and reimbursement for the services rendered in managing thigh fractures.
When billing for CPT code 27502, which pertains to the treatment of a thigh fracture, 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 58 - Staged or Related Procedure or Service by the Same Physician
Used when a procedure is planned or anticipated as part of a staged treatment.
4. Modifier 59 - Distinct Procedural Service
Indicates that a procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician
Used when the same procedure is repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician
Indicates that the same procedure was performed by a different physician.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician
Used when a patient requires an unplanned return to the operating room for a related procedure.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Indicates that a procedure is unrelated to the original procedure performed during the postoperative period.
9. Modifier LT - Left Side
Used to specify that the procedure was performed on the left side of the body.
10. Modifier RT - Right Side
Used to specify that the procedure was performed on the right side of the body.
11. Modifier 22 - Increased Procedural Services
Indicates that the service provided was significantly greater than what is typically required for the procedure.
12. Modifier 27 - Multiple Encounters on the Same Date
Used when a patient has multiple encounters on the same date of service.
It is essential for healthcare providers to select the appropriate modifiers based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 27502 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 corresponding 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 27502. Each MAC may have unique policies and procedures, so staying informed through these channels ensures accurate and timely reimbursement.
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 27502, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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