CPT code 27615 is for the surgical removal of a leg or ankle tumor that is less than 5 cm in size.
CPT code 27615 is used to describe the surgical procedure for resecting a tumor located in the leg or ankle that is less than 5 centimeters in size. This code indicates that the healthcare provider has performed an excision of the tumor, which involves removing the tumor along with some surrounding tissue to ensure complete removal and minimize the risk of recurrence.
When billing for the CPT code 27615, there are several modifiers that 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/ankles.
2. Modifier 51 - Multiple Procedures: This modifier should be applied if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure: This modifier is appropriate if the procedure is a staged or related procedure that is performed during the postoperative period of another procedure.
4. Modifier 59 - Distinct Procedural Service: Use this modifier when 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 applicable if the procedure is repeated by the same physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier should be used if the 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: This modifier is relevant if a different procedure is performed by the same physician during the postoperative period.
8. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: This modifier is appropriate if an unrelated evaluation and management service is provided during the postoperative period.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier can be used when multiple encounters occur 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 27615 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, including the associated payment rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and fee schedules. Therefore, healthcare providers should consult their respective MAC for precise information on the reimbursement rate and any specific billing requirements for CPT code 27615.
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