CPT code 20663 is for the application of a thigh brace, used to support and stabilize the thigh area.
CPT code 20663 is for the application of a thigh brace. This code is used when a healthcare provider fits and applies a brace specifically designed to support and stabilize the thigh.
For CPT code 20663, which pertains to the application of a thigh brace, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Use this modifier if the procedure required significantly more effort or time than typically required.
2. Modifier 52 - Reduced Services
- Apply this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
3. Modifier 59 - Distinct Procedural Service
- This modifier is used to indicate that the application of the thigh brace was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician
- Use this modifier if the same physician needs to repeat the application of the thigh brace within a short period.
5. Modifier 77 - Repeat Procedure by Another Physician
- Apply this modifier if a different physician repeats the application of the thigh brace.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Use this modifier if the application of the thigh brace is unrelated to the original procedure and occurs during the postoperative period.
8. Modifier 99 - Multiple Modifiers
- Apply this modifier if more than four modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used according to the specific circumstances surrounding the application of the thigh brace. Proper use of these modifiers ensures accurate billing and reimbursement.
Medicare reimbursement for CPT code 20663, which pertains to the application of a thigh brace, depends on several factors including the medical necessity, the setting in which the service is provided, and the specific Medicare plan. Generally, Medicare Part B may cover the cost of durable medical equipment (DME) like a thigh brace if it is deemed medically necessary by a healthcare provider. However, the exact reimbursement amount can vary based on geographic location and other variables.
To determine if CPT code 20663 is reimbursed by Medicare and to find the specific reimbursement amount, healthcare providers should consult the Medicare Physician Fee Schedule (MPFS) or use the Medicare Administrative Contractor (MAC) resources. Additionally, providers can verify coverage and reimbursement rates through the Medicare Coverage Database or by contacting their local MAC directly.
For the most accurate and up-to-date information, it is advisable to check the latest Medicare guidelines or consult with a billing specialist who can provide detailed insights based on the specific circumstances of the service provided.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 20663 for the application of a thigh brace. Ensure you're receiving the full reimbursement you deserve from each payer. Schedule a demo today to see RevFind in action and protect your revenue.
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