CPT code 60240 is a medical code used to describe the procedure for the removal of the thyroid gland.
CPT code 60240 is a surgical procedure used to remove the thyroid gland, either in whole or in part, during a thyroidectomy.
When billing for the procedure associated with CPT code 60240, which involves the removal of the thyroid, certain modifiers may be necessary to provide additional information about the service rendered. Here is a list of potential modifiers that could be used, along with the reasons for their application:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. For example, if there are complications or additional work due to patient anatomy or other factors, this modifier may be appropriate.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier indicates that the service was bilateral.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.
4. Modifier 52 - Reduced Services: This modifier is applicable if the procedure was partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: If the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier should be used.
6. 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.
7. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, each acting as a primary surgeon, this modifier is used to indicate the collaborative effort.
8. Modifier 66 - Surgical Team: When a complex procedure requires a surgical team, this modifier is used to indicate that multiple professionals were involved.
9. Modifier 76 - Repeat Procedure by Same Physician: If the same physician needs to repeat the procedure, this modifier is used to indicate the repetition.
10. Modifier 77 - Repeat Procedure by Another Physician: If a different physician repeats the procedure, this modifier is used to indicate the repetition by another provider.
11. 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 when the patient requires a return to the operating room for a related procedure during the postoperative period.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier is used.
13. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required to help with the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: If a minimum assistant surgeon is required, this modifier is used to indicate their involvement.
15. 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.
16. Modifier 99 - Multiple Modifiers: When multiple modifiers are applicable, this modifier is used to indicate that more than one modifier is necessary for the procedure.
These modifiers help provide a more comprehensive understanding of the circumstances surrounding the procedure and ensure accurate billing and reimbursement. It's important to review payer-specific guidelines, as the use of modifiers can vary based on the insurance provider's policies.
The CPT code 60240 is reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. However, the reimbursement for CPT code 60240 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing Medicare claims and setting specific reimbursement rates within their jurisdiction, ensuring that providers are compensated according to regional cost variations and other considerations. Therefore, while CPT code 60240 is generally reimbursed by Medicare, the exact reimbursement amount should be verified with the relevant MAC.
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