CPT code 73120 is used for documenting an X-ray exam of the hand, detailing the procedure for accurate medical record-keeping and reimbursement.
CPT code 73120 is used to describe an X-ray examination of the hand. This code is specifically for a radiological procedure that involves taking two or more views of the hand to assess for any abnormalities, fractures, or other conditions. The X-ray images help healthcare providers diagnose issues related to bones, joints, and soft tissues in the hand. This code is typically used in billing and documentation to ensure accurate reimbursement for the radiological services provided.
1. Modifier 26 (Professional Component): This modifier is used when only the professional component of the service is being billed. It is applicable if the healthcare provider is only interpreting the x-ray and not providing the technical component, such as operating the x-ray machine.
2. Modifier TC (Technical Component): This modifier is used when only the technical component of the service is being billed. It applies if the healthcare provider is responsible for the technical aspect, such as taking the x-ray, but not interpreting it.
3. Modifier 59 (Distinct Procedural Service): This modifier may be used if the x-ray is performed in conjunction with another procedure, and it is necessary to indicate that the x-ray is a distinct service from other procedures performed on the same day.
4. Modifier 76 (Repeat Procedure by Same Physician): This modifier is applicable if the x-ray needs to be repeated on the same day by the same physician due to medical necessity.
5. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used if the x-ray is repeated on the same day by a different physician, again due to medical necessity.
6. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test): Although primarily used for laboratory tests, this modifier can sometimes be applied to diagnostic tests like x-rays if they need to be repeated for the same patient on the same day for valid medical reasons.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered.
The CPT code 73120 is reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS). The MPFS outlines the payment rates for services covered under Medicare Part B, and CPT code 73120 is among those services.
However, it's important to note that reimbursement rates and coverage can vary based on geographic location and specific Medicare Administrative Contractor (MAC) policies. Each MAC is responsible for processing claims and determining coverage specifics within their jurisdiction, so healthcare providers should verify the reimbursement details with their respective MAC to ensure accurate billing and payment.
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