CPT code 27692 is for the revision of an additional leg tendon, used to describe specific surgical procedures in healthcare billing.
CPT code 27692 is used to describe a surgical procedure that involves the revision of an additional tendon in the leg. This procedure typically aims to correct issues related to tendon function, such as tears or other injuries, ensuring proper alignment and stability in the affected area. It is often performed to improve mobility and restore normal function in patients experiencing complications from previous tendon surgeries or injuries.
When billing for the CPT code 27692, 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 legs.
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: This modifier is appropriate if the procedure is a staged or related procedure that is performed during the postoperative period of another procedure.
4. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient requires a return to the operating room for a related procedure within the postoperative period.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier is applicable if a different procedure is performed by the same provider during the postoperative period.
6. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
7. Modifier 26 - Professional Component: If the service has both a professional and technical component, this modifier should be used to indicate that only the professional component is being billed.
8. Modifier TC - Technical Component: Similar to Modifier 26, this modifier indicates that only the technical component of the service is being billed.
9. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used if the procedure is repeated on the same day.
10. Modifier 99 - Multiple Modifiers: This modifier is used when more than one modifier is applicable to the procedure.
It is essential to select the appropriate modifier(s) based on the specific circumstances surrounding the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 27692 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, along with the corresponding reimbursement rates. To determine the exact reimbursement for CPT code 27692, healthcare providers should consult the MPFS for the current year.
Additionally, it is important to note that Medicare Administrative Contractors (MACs) play a crucial role in processing claims and determining coverage specifics. MACs may have localized policies that affect the reimbursement of CPT code 27692. Therefore, providers should also check with their respective MAC to ensure compliance with any regional guidelines or additional documentation requirements that may impact reimbursement.
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 27692, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can optimize your financial performance.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
