CPT code 29827 is a medical billing code for shoulder arthroscopy surgery to repair a rotator cuff.
CPT code 29827 is a surgical procedure that involves the repair of a rotator cuff in the shoulder joint. This code specifically refers to an arthroscopic approach, which means the surgery is performed using small incisions and a camera to guide the surgeon. The procedure aims to address tears in the rotator cuff, which can cause pain and limit shoulder movement, ultimately helping to restore function and alleviate discomfort for the patient.
When billing for CPT code 29827, 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 is applicable when multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that a procedure is distinct or independent from other services performed on the same day.
4. 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.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier indicates that the same procedure was performed by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is used when a patient requires a return to the operating room for a related procedure within the global period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is applicable when a procedure is performed that is unrelated to the original procedure during the postoperative period.
8. Modifier LT - Left Side: Use this modifier to specify that the procedure was performed on the left side of the body.
9. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right side of the body.
10. Modifier AS - Physician Assistant/ Nurse Practitioner/ Clinical Nurse Specialist: This modifier is used when the service is performed by a non-physician provider.
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 29827 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides a comprehensive list of the payment rates for services covered by Medicare, including CPT code 29827. To determine the exact reimbursement rate for this code, healthcare providers should refer to the MPFS, which is updated annually.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing claims and determining local coverage decisions. Each MAC may have specific guidelines and policies that can influence the reimbursement for CPT code 29827. Therefore, it is essential for healthcare providers to consult their respective MAC for detailed information on coverage and reimbursement rates for this particular CPT code.
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 CPT code 29827 and ensure you are receiving the correct reimbursements. Schedule a demo today to see how RevFind can help you optimize your revenue.
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