CPT code 63077 is for a surgical procedure involving the removal of a disc in the thoracic spine to relieve pressure on the spinal cord or nerves.
CPT code 63077 is used to describe a surgical procedure known as a discectomy, which is performed from the front (anterior) of the body. This procedure involves the removal of a herniated or damaged disc in the thoracic region of the spine, which is the middle section of the spine. The surgery aims to relieve pressure on the spinal cord and/or nerve roots, which can be caused by the disc pressing against them. Additionally, the procedure may include an osteophytectomy, which is the removal of bone spurs (osteophytes) that can also contribute to nerve compression. This code is applicable when the procedure is performed at a single interspace in the thoracic spine.
For CPT code 63077, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to unusual anatomy or complications that arose during the surgery.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be used to indicate that the surgery was bilateral.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier should be used to indicate that more than one procedure was conducted.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if the discectomy was performed in conjunction with other procedures that are not typically reported together.
5. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be used to indicate the repetition.
6. Modifier 77 - Repeat Procedure by Another Physician: If the procedure is repeated by a different physician, this modifier should be used.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier if the patient needs to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required during the procedure, this modifier should be used to indicate their involvement.
10. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is involved in the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
12. Modifier 99 - Multiple Modifiers: If more than four modifiers are necessary to describe the procedure, this modifier indicates that multiple modifiers are being used.
Each modifier should be used in accordance with the specific circumstances of the procedure and the payer's guidelines to ensure accurate billing and reimbursement.
CPT code 63077 is reimbursed by Medicare, but the reimbursement is subject to several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered under Medicare Part B, including surgical procedures like those represented by CPT code 63077. The reimbursement amount can vary based on geographic location and other factors, as determined by the Medicare Administrative Contractor (MAC) responsible for processing claims in a specific region. Each MAC may have slightly different interpretations and guidelines, so it is crucial for healthcare providers to verify the specific reimbursement details with their local MAC to ensure accurate billing and optimal reimbursement for CPT code 63077.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 63077, and by individual payer. Don't let underpayments slip through the cracks—schedule a demo today to see how RevFind can enhance your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
