CPT code 27659 is a medical billing code used for the repair of a leg tendon, indicating a specific surgical procedure.
CPT code 27659 is used to describe the surgical procedure for the repair of a tendon in the leg. This code specifically refers to the repair of each tendon, indicating that if multiple tendons are repaired during the same surgical session, each would be billed separately under this code. This procedure typically involves suturing or reconnecting the tendon to restore its function and integrity, which is crucial for movement and stability in the leg.
When billing for CPT code 27659 (Repair of leg tendon each), several modifiers 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 during the same session.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if multiple procedures are performed during the same session, indicating that this is not the primary procedure.
3. Modifier 58 - Staged or Related Procedure: Use this modifier if the repair is part of a staged procedure or if it is a subsequent procedure related to the initial surgery.
4. Modifier 59 - Distinct Procedural Service: This modifier is used 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 same procedure is performed again by the same physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating Room: Use this modifier if the patient requires a return to the operating room for a related procedure within the global period.
7. Modifier 79 - Unrelated Procedure by the Same Physician: This modifier is used if a procedure is performed that is unrelated to the original procedure during the global period.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right leg.
9. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left leg.
10. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements.
The CPT code 27659 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).
The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates. Additionally, the reimbursement for CPT code 27659 may vary depending on the local policies of the Medicare Administrative Contractor (MAC) that oversees the specific geographic region where the service is provided.
It is essential for healthcare providers to consult the MPFS and their respective MAC guidelines to ensure compliance and accurate reimbursement for CPT code 27659.
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 and by individual payer. With RevFind, you can identify discrepancies for specific codes like 27659, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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