CPT code 27507 is used to describe the treatment procedure for a thigh fracture, detailing the specific medical service provided.
CPT code 27507 is used to describe the surgical treatment of a fracture in the thigh bone (femur). This code specifically refers to the procedure where the fractured thigh is stabilized, often through internal fixation methods such as the use of plates or screws, to promote proper healing and restore function.
When billing for CPT code 27507, which pertains to the treatment of a thigh fracture, 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 thighs.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure: This modifier should be used if the procedure is a staged procedure or if it is related to a previous procedure performed during the same surgical episode.
4. Modifier 59 - Distinct Procedural Service: This modifier is applicable when the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated by the same 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 complications related to the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is used if a procedure is performed that is unrelated to the original procedure during the postoperative period.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right thigh.
9. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left thigh.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
Each of these modifiers serves to provide additional context to the procedure being billed, ensuring accurate reimbursement and compliance with payer requirements.
The CPT code 27507 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 27507. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement. Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 27507.
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, including specific codes like 27507. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and optimize your revenue.
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
