CPT code 27745 is used to describe the procedure of reinforcing the tibia, a key bone in the lower leg, during surgical interventions.
CPT code 27745 is used to describe a surgical procedure that involves reinforcing the tibia, which is the larger bone in the lower leg. This procedure typically aims to stabilize the bone, often following a fracture or injury, by using various techniques or materials to enhance its strength and support healing.
When billing for the CPT code 27745, 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 sides of the body.
2. Modifier 51 - Multiple Procedures: This modifier should be applied when multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier indicates that a procedure is distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side: Use this modifier to specify that the procedure was performed on the left side of the body.
5. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right side of the body.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier applies when the same procedure is repeated by a different physician on the same day.
8. Modifier 22 - Increased Procedural Services: This modifier is appropriate if the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: Use this modifier if an unrelated service is provided during the postoperative period.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is used when a patient has multiple encounters on the same date of service.
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 27745 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 27745 may vary depending on the local policies of the Medicare Administrative Contractor (MAC) that services your geographic region. It is essential to consult the MPFS and your regional MAC guidelines to determine the exact reimbursement details and any additional requirements for this specific CPT code.
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