CPT code 27664 is for the surgical repair of a leg tendon, detailing the specific procedure for billing and documentation in healthcare.
CPT code 27664 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 documented separately using this code. The procedure typically involves suturing or reconnecting the tendon to restore its function and integrity, which is crucial for the patient's mobility and overall leg function.
When billing for CPT code 27664 (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.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional: This modifier should be used if the repair is part of a staged procedure or if it is a subsequent procedure related to the initial repair.
4. Modifier 59 - Distinct Procedural Service: This modifier is applicable when the procedure is performed separately from other procedures on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier 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 Following Initial Procedure for a Related Procedure: This modifier is relevant if a 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 completely unrelated procedure is performed during the postoperative period of the initial procedure.
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: 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.
The CPT code 27664 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 fees and reimbursement rates for various CPT codes, including 27664. Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 27664.
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 the ability to identify discrepancies for specific codes like 27664, you can ensure that your practice is receiving the full reimbursement it deserves. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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