CPT Code 24358

CPT code 24357 is a medical code used to describe a percutaneous repair procedure on the elbow.

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What is CPT Code 24358

CPT code 24358 is used to describe the surgical procedure for repairing an elbow, specifically when the repair is done with a debridement (removal of damaged tissue) and the procedure is performed through an open incision. This code is typically used by healthcare providers to document and bill for this specific type of elbow repair surgery.

Does CPT 24358 Need a Modifier?

For CPT code 24358 (Repair elbow w/debridement, open), the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or unusual circumstances.

2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both elbows during the same session, this modifier should be used.

3. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier should be appended to indicate that more than one procedure was performed.

4. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.

5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day.

6. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be used.

7. Modifier 77 - Repeat Procedure by Another Physician: If the procedure is repeated by a different physician, this modifier should be appended.

8. 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.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.

10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier should be used.

11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required.

12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.

13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Use this modifier when these non-physician practitioners assist in the surgery.

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.

CPT Code 24358 Medicare Reimbursement

CPT code 24358 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates and guidelines for services covered under Medicare Part B. Additionally, the reimbursement for CPT code 24358 may vary depending on the policies of the Medicare Administrative Contractor (MAC) that oversees the specific geographic region where the service is provided. It is essential to consult the local MAC for precise coverage details and any additional requirements that may apply.

Are You Being Underpaid for 24358 CPT Code?

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