CPT code 27767 is used to describe the surgical procedure for the closed treatment of a post-traumatic ankle fracture. This code indicates that the healthcare provider has performed a manipulation of the fractured ankle without making an incision, typically involving the realignment of the bone fragments to ensure proper healing. This procedure may also include the application of a cast or splint to stabilize the ankle after the manipulation.
CPT code 27767 is used to describe the surgical procedure for the closed treatment of a post-traumatic ankle fracture. This code indicates that the healthcare provider has performed a manipulation of the fractured ankle without making an incision, typically involving the realignment of the bones to ensure proper healing. This procedure may also include the application of a cast or splint to stabilize the ankle following the manipulation.
When billing for CPT code 27767, which pertains to a clinical procedure, several modifiers may be applicable depending on the specific circumstances of the service provided. Below is a list of potential modifiers that could be used with this code, along with the reasons for their use:
1. Modifier 50 - Bilateral Procedure
Used when the procedure is performed on both sides of the body.
2. Modifier 51 - Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician
Used when a procedure is performed in a staged manner or when a subsequent procedure is related to the initial procedure.
4. Modifier 59 - Distinct Procedural Service
Indicates that a procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure or Service by Same Physician
Used when the same 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
Indicates an unplanned return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Used when a procedure is performed that is unrelated to the original procedure during the postoperative period.
8. Modifier LT - Left Side
Indicates that the procedure was performed on the left side of the body.
9. Modifier RT - Right Side
Indicates that the procedure was performed on the right side of the body.
10. Modifier 22 - Increased Procedural Services
Used when the work required to provide a service is substantially greater than typically required.
It is essential for healthcare providers 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 27767 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any additional requirements, healthcare providers should consult the MPFS, which provides detailed information on the payment rates for all CPT codes.
Additionally, it is essential to verify with the local Medicare Administrative Contractor (MAC) as they may have specific guidelines or coverage determinations that could affect reimbursement. Each MAC may have unique policies that influence whether and how a particular CPT code is reimbursed, so checking with the appropriate MAC is a crucial step in the process.
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. For instance, with RevFind, you can identify discrepancies related to CPT code 27767, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can optimize your revenue recovery process.
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