CPT code 27591 is used to describe the procedure of amputating a leg at the thigh level in medical billing and documentation.
CPT code 27591 is used to describe the surgical procedure of amputating the leg at the thigh level. This code specifically indicates that the amputation is performed above the knee, which may be necessary due to various medical conditions such as severe trauma, infection, or vascular disease. The code helps healthcare providers and insurers identify and categorize this specific type of surgical intervention for billing and documentation purposes.
When billing for the CPT code 27591, which pertains to the amputation of the leg at the thigh, 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: This modifier is used when the procedure is performed on both legs, indicating that the amputation was bilateral.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if multiple surgical procedures are performed during the same session, including the amputation.
3. Modifier 58 - Staged or Related Procedure: This modifier is used when the amputation is part of a staged procedure or if it is a subsequent procedure related to an earlier surgery.
4. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is appropriate if the patient requires a return to the operating room for complications related to the amputation.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is used if a different procedure is performed during the postoperative period that is unrelated to the amputation.
6. Modifier 26 - Professional Component: This modifier indicates that only the professional component of the service is being billed, which may be relevant if the procedure involves interpretation or evaluation.
7. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed, which may apply if the facility is billing separately for the technical aspects of the procedure.
8. Modifier KX - Requirements Met: This modifier is used to indicate that the requirements for coverage of the procedure have been met, which may be necessary for certain payers.
9. Modifier QZ - Service(s) Delivered by a Nurse Anesthetist: This modifier is applicable if the anesthesia for the procedure was provided by a nurse anesthetist.
10. Modifier AS - Physician Assistant Services: This modifier is used when a physician assistant performs the procedure under the supervision of a physician.
Each of these modifiers serves a specific purpose and should be used based on the details of the procedure and the payer's requirements. Proper use of modifiers can help ensure accurate billing and reimbursement for the services provided.
CPT code 27591 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and reimbursement policies for CPT code 27591. It is essential for healthcare providers to consult both the MPFS and their respective MAC to ensure compliance with Medicare's billing and documentation requirements for this particular code.
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. For instance, with CPT code 27591, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
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
