CPT code 29874 is used to describe knee arthroscopy, a minimally invasive surgery to diagnose and treat knee joint issues.
CPT code 29874 is used to describe a specific surgical procedure involving knee arthroscopy. This code indicates that the procedure includes the surgical intervention for the knee joint, typically involving the removal of loose bodies, repair of damaged cartilage, or treatment of other knee-related issues through minimally invasive techniques. It is commonly utilized by healthcare providers to document and bill for the surgical services rendered during knee arthroscopy.
When billing for CPT code 29874, 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: This modifier is used when the procedure is performed on both knees during the same session.
2. Modifier 51 - Multiple Procedures: This modifier indicates that multiple procedures were performed during the same session, which may affect reimbursement.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable when the same procedure is performed more than once by the same physician on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is performed by a different physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier indicates that a patient returned to the operating room for a related procedure within the global period of the original procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed that is unrelated to the original procedure during the postoperative period.
8. Modifier LT - Left Side: This modifier specifies that the procedure was performed on the left knee.
9. Modifier RT - Right Side: This modifier specifies that the procedure was performed on the right knee.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and reimbursement.
The CPT code 29874 is reimbursed by Medicare, but the reimbursement amount can vary based on several factors. To determine the specific reimbursement rate, you should refer to the Medicare Physician Fee Schedule (MPFS), which provides detailed information on the payment rates for various CPT codes. Additionally, the reimbursement can be influenced by the local policies of the Medicare Administrative Contractor (MAC) that services your region. Each MAC may have specific guidelines and rates, so it is essential to consult with your local MAC for precise information regarding the reimbursement of CPT code 29874.
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, including specific cases like 29874. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and optimize your revenue.
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