CPT code 27618 is used to describe the excision of a leg or ankle tumor that is less than 3 cm in size.
CPT code 27618 is used to describe the excision of a tumor located in the leg or ankle that measures less than 3 centimeters in size. This procedure involves the surgical removal of the tumor, which may be necessary for diagnostic purposes or to eliminate a growth that could be harmful.
When billing for CPT code 27618, which pertains to excision of a leg or ankle tumor less than 3 cm, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used with this code, along with the reasons for their use:
1. Modifier 50 - Bilateral Procedure
Used when the procedure is performed on both legs or ankles.
2. Modifier 51 - Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. Modifier 59 - Distinct Procedural Service
Used to indicate that the procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician
Applied when the same procedure is repeated by the same physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room
Indicates that a patient returned to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Used when a procedure is performed that is unrelated to the original procedure during the postoperative period.
7. Modifier LT - Left Side
Specifies that the procedure was performed on the left leg or ankle.
8. Modifier RT - Right Side
Specifies that the procedure was performed on the right leg or ankle.
9. Modifier 22 - Increased Procedural Services
Indicates that the work required to provide the service was substantially greater than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date
Used when a patient has multiple encounters on the same date of service.
It is essential for healthcare providers to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and reimbursement.
CPT code 27618 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 reimbursement rates.
Additionally, it is crucial to consult with your local Medicare Administrative Contractor (MAC) to confirm any regional variations or specific billing requirements that may apply to CPT code 27618. Each MAC may have unique guidelines and policies that could impact the reimbursement process.
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, including specific codes like 27618. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and optimize your revenue.
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