CPT code 27514 is used to describe the treatment of a thigh fracture, detailing the specific procedure performed by healthcare providers.
CPT code 27514 is used to describe the surgical treatment of a fracture in the thigh bone (femur). This code specifically refers to the procedure involving the stabilization or repair of the fracture, which may include methods such as internal fixation or other surgical techniques to ensure proper healing and alignment of the bone.
When billing for CPT code 27514, 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 applicable if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure: Use this modifier if the treatment is part of a staged procedure or if it is a subsequent procedure related to the initial treatment.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the procedure is repeated by the same 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 by Same Physician: This modifier is applicable if a procedure is performed that is unrelated to the original procedure during the global period.
8. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right thigh.
9. Modifier LT - Left Side: Use this modifier if the procedure is 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 for the billing process, ensuring accurate reimbursement and compliance with payer requirements.
CPT code 27514 is reimbursed by Medicare, but the specifics of reimbursement can vary. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered under Medicare Part B, including CPT code 27514. However, the final determination of reimbursement is often managed by the Medicare Administrative Contractor (MAC) for your specific region. MACs are responsible for processing Medicare claims and can provide detailed information on coverage policies and reimbursement rates for CPT code 27514. It is advisable to consult the MPFS and your regional MAC to confirm the exact reimbursement details for this code.
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