CPT code 27590 is used to describe the procedure of amputating a leg at the thigh level in medical billing and documentation.
CPT code 27590 is used to describe the surgical procedure of amputating the leg at the thigh level. This code indicates that the entire leg is removed above the knee joint, which may be necessary due to severe injury, disease, or other medical conditions affecting the limb.
When billing for the CPT code 27590 (Amputate leg at thigh), the following modifiers may be applicable, depending on the specific circumstances of the procedure:
1. Modifier -50: Bilateral Procedure
- Used when the procedure is performed on both legs.
2. Modifier -RT: Right Side
- Indicates that the procedure was performed on the right leg.
3. Modifier -LT: Left Side
- Indicates that the procedure was performed on the left leg.
4. Modifier -59: Distinct Procedural Service
- Used to indicate that the procedure is separate and distinct from other services performed on the same day.
5. Modifier -76: Repeat Procedure by Same Physician
- Indicates that the procedure was repeated by the same physician on the same day.
6. Modifier -78: Unplanned Return to the Operating/Procedure Room
- Used when a patient returns to the operating room for a related procedure during the postoperative period.
7. Modifier -79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that a different procedure was performed by the same physician during the postoperative period.
8. Modifier -AS: Physician Assistant or Nurse Practitioner Services
- Used when a physician assistant or nurse practitioner performs the procedure under the supervision of a physician.
These modifiers help provide additional context for the procedure and ensure accurate billing and reimbursement. It is essential to select the appropriate modifier based on the specific circumstances surrounding the procedure to avoid claim denials and ensure compliance with payer requirements.
The CPT code 27590 is reimbursed by Medicare, but the specifics of reimbursement can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides a comprehensive list of the payment rates for services covered by Medicare, including CPT code 27590. However, the final determination of reimbursement is often influenced by the local policies of the Medicare Administrative Contractor (MAC) that services your region. Each MAC may have specific guidelines and coverage criteria that could affect whether and how much Medicare reimburses for CPT code 27590. Therefore, it is essential to consult both the MPFS and your local MAC's policies to get a precise understanding of the reimbursement details for this code.
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