CPT code 27646 is used to describe the surgical procedure for resecting a tumor from the fibula bone.
CPT code 27646 is used to describe the surgical procedure of resecting a tumor located on the fibula, which is one of the two bones in the lower leg. This code indicates that the healthcare provider has performed an excision of the tumor, which may involve removing a portion of the fibula along with the tumor itself. This procedure is typically carried out to eliminate cancerous or benign growths and may be part of a broader treatment plan for the patient.
When billing for the CPT code 27646 (Resect fibula tumor), 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 sides of the body.
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 or Service 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 by the Same Physician
Used when a patient returns 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
Indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
7. Modifier LT - Left Side
Used to specify that the procedure was performed on the left side of the body.
8. Modifier RT - Right Side
Used to specify that the procedure was performed on the right side of the body.
9. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services
Indicates that the service was performed by a non-physician provider under the supervision of a physician.
10. Modifier 22 - Increased Procedural Services
Used when the work required to provide a service is substantially greater than typically required.
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 27646 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 advisable to consult with your regional Medicare Administrative Contractor (MAC) for any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 27646.
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