CPT code 27517 is used to describe the treatment of a thigh fracture involving the growth plate in medical billing and coding.
CPT code 27517 is used to describe the surgical procedure for treating a fracture of the femur (thigh bone) that involves the growth plate. This code specifically indicates that the procedure addresses a fracture in a pediatric patient, where the growth plate is critical for bone development. The treatment may involve stabilization or repair to ensure proper healing and growth of the bone.
When billing for CPT code 27517, which pertains to the treatment of a thigh fracture involving the growth plate, 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 or related procedure that is performed during the postoperative period.
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 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient requires an unplanned return to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is appropriate if a different procedure is performed by the same physician during the postoperative period that is unrelated to the original procedure.
7. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left thigh specifically.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right thigh specifically.
9. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is applicable if the patient has multiple encounters on the same date of service.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 27517 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 payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and fee schedules. Therefore, it is advisable to consult the relevant MAC for precise information regarding the reimbursement of CPT code 27517 in your specific area.
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