CPT code 27647 is for the surgical procedure to remove a tumor from the talus or calcaneus bones in the foot.
CPT code 27647 is used to describe a surgical procedure involving the resection of a tumor located in the talus or calcaneus bones of the foot. This procedure typically involves the removal of the tumor along with a portion of the surrounding bone to ensure complete excision and to address any potential malignancy. It is often performed to alleviate pain, restore function, and prevent the spread of cancerous cells.
When billing for the CPT code 27647, 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 limbs.
2. Modifier 51 - Multiple Procedures: This modifier should be applied when multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician: This modifier is appropriate if the procedure is a staged procedure or if it is related to a previous procedure performed by the same physician.
4. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that 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 by the Same Physician: This modifier should be used if the patient requires an unplanned return to the operating room for a related procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a procedure is performed that is unrelated to the original procedure during the postoperative period.
8. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left side of the body.
9. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right side of the body.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work 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.
CPT code 27647 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides a comprehensive list of services covered by Medicare, including the reimbursement rates for each CPT code. To determine the exact reimbursement for CPT code 27647, healthcare providers should refer to the MPFS.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide region-specific information regarding the reimbursement of CPT code 27647. Providers should consult their respective MAC for detailed guidance on the reimbursement policies and any potential local coverage determinations (LCDs) that might affect the payment for this specific CPT code.
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