CPT code 27637 is used for the procedure of removing or grafting a bone lesion in the leg.
CPT code 27637 is used to describe the surgical procedure for the removal or grafting of a lesion located in the leg bone. This code indicates that a healthcare provider has performed an intervention to either excise a problematic area of bone or to repair it using grafting techniques, which may involve the use of bone from another site or a synthetic material. This procedure is typically indicated for conditions such as tumors, infections, or other abnormalities affecting the leg bone.
When billing for the CPT code 27637, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used, along with the reasons for their application:
1. Modifier 50 - Bilateral Procedure
Used when the procedure is performed on both legs.
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 LT - Left Side
Indicates that the procedure was performed on the left leg.
5. Modifier RT - Right Side
Indicates that the procedure was performed on the right leg.
6. Modifier 22 - Increased Procedural Services
Used when the procedure required significantly more work than typically required.
7. Modifier 76 - Repeat Procedure or Service by Same Physician
Indicates that the same procedure was performed again by the same provider.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room
Used when a patient returns to the operating room for a related procedure within the global period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Indicates that a procedure unrelated to the original procedure was performed during the postoperative period.
10. Modifier 92 - Alternative Laboratory Platform Testing
Used when the procedure is performed using an alternative laboratory platform.
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 27637 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their respective reimbursement rates. Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may apply to CPT code 27637.
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