CPT code 27604 is a medical billing code used to describe the procedure of draining a bursa in the lower leg.
CPT code 27604 is used to describe the procedure of draining fluid from the bursa located in the lower leg. This typically involves the use of a needle or small incision to remove excess fluid that may be causing swelling or discomfort in the area. The procedure is often performed to relieve pain or to facilitate further evaluation of the underlying condition.
When billing for the CPT code 27604 (Drain lower leg bursa), 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 legs.
2. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is performed separately from other procedures on the same day, indicating that it is not part of a bundled service.
3. Modifier LT - Left Side: Use this modifier when the procedure is performed on the left leg.
4. Modifier RT - Right Side: Use this modifier when the procedure is performed on the right leg.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable 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 or Service by the Same Physician During the Postoperative Period: This modifier is used if a different procedure is performed by the same physician during the postoperative period of the original procedure.
8. 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 procedure performed, ensuring accurate billing and appropriate reimbursement.
The CPT code 27604 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of CPT codes along with their corresponding reimbursement rates, while the MAC offers localized guidance and policies that may affect reimbursement.
Always consult these resources to ensure accurate and up-to-date information regarding the reimbursement status of CPT code 27604.
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. With RevFind, you can identify discrepancies for specific CPT code 27604, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can streamline your processes and improve your bottom line.
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