CPT code 29835 is a medical billing code for elbow arthroscopy, a minimally invasive surgical procedure on the elbow joint.
CPT code 29835 is used to describe a surgical procedure involving elbow arthroscopy. This code specifically refers to the arthroscopic examination and treatment of the elbow joint, which may include procedures such as removing loose bodies, repairing ligaments, or addressing other joint issues. It is commonly utilized by healthcare providers to document and bill for minimally invasive surgical interventions performed on the elbow.
When billing for CPT code 29835, which pertains to elbow arthroscopy/surgery, 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 elbows during the same session.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if multiple surgical procedures are performed during the same operative session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used when the procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the procedure is repeated by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the procedure is repeated by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is relevant if the 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 used if a different procedure is performed by the same physician during the postoperative period of the original procedure.
8. Modifier 22 - Increased Procedural Services: This modifier may be used 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: This modifier is applicable if an unrelated E/M service is provided during the postoperative period.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier can be used if multiple outpatient E/M encounters occur 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 29835 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. However, the final determination of reimbursement for CPT code 29835 can also depend on the guidelines set forth by the Medicare Administrative Contractor (MAC) for your specific region. MACs are responsible for processing Medicare claims and can have localized policies that affect reimbursement. Therefore, it is essential to consult both the MPFS and your regional MAC to confirm the reimbursement status and any additional requirements for CPT code 29835.
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 29835 and ensure you are receiving the correct reimbursement. Schedule a demo today to see how RevFind can help you optimize your revenue.
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