CPT code 27880 is the code used for the surgical amputation of the lower leg, detailing the procedure for billing and documentation purposes.
CPT code 27880 is the code used for the surgical procedure involving the amputation of the lower leg. This procedure typically entails the removal of the leg below the knee, which may be necessary due to severe injury, infection, or other medical conditions that compromise the viability of the limb.
When billing for CPT code 27880 (Amputation of lower leg), 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
- Used when the procedure is performed on both lower legs.
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 the amputation is part of a staged procedure or if a subsequent procedure is planned.
4. Modifier -76: Repeat Procedure by Same Physician
- Indicates that the same procedure was performed more than once by the same physician on the same day.
5. Modifier -78: Unplanned Return to the Operating/Procedure Room by the Same Physician
- Used if the patient requires an unplanned return to the operating room for complications related to the initial procedure.
6. Modifier -79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that a different procedure was performed during the postoperative period that is unrelated to the original procedure.
7. Modifier -RT: Right Side
- Used to specify that the procedure was performed on the right lower leg.
8. Modifier -LT: Left Side
- Used to specify that the procedure was performed on the left lower leg.
9. Modifier -KX: Requirements Met
- Indicates that the requirements for coverage of the procedure have been met, often used for Medicare billing.
10. Modifier -QZ: Service Delivered Under a Fee-for-Service Arrangement
- Used when the service is provided under a specific arrangement that affects billing.
These modifiers help to provide additional context for the procedure performed and ensure accurate billing and reimbursement. It is essential to select the appropriate modifiers based on the specific circumstances surrounding the procedure to avoid claim denials and ensure compliance with payer requirements.
The CPT code 27880 is reimbursed by Medicare, but the reimbursement is subject to several factors.
The Medicare Physician Fee Schedule (MPFS) outlines the payment rates for services, including CPT code 27880.
However, the final determination of reimbursement is made by the Medicare Administrative Contractor (MAC) for your specific region.
Each MAC may have different local coverage determinations (LCDs) and policies that could affect whether and how much CPT code 27880 is reimbursed.
Therefore, it is essential to consult the MPFS and your regional MAC for the most accurate and up-to-date information regarding reimbursement for CPT code 27880.
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