CPT code 60280 is a medical code used to describe the procedure for removing a lesion from the thyroid duct.
CPT code 60280 is a surgical procedure for the removal of a thyroid duct lesion, involving the excision of abnormal tissue along the path of the embryonic thyroid duct.
When dealing with the CPT code 60280 for the removal of a thyroid duct lesion, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to factors such as increased complexity or time.
2. Modifier 51 - Multiple Procedures: If the removal of the thyroid duct lesion is performed in conjunction with other procedures during the same surgical session, this modifier indicates that multiple procedures were performed.
3. 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 is often used to bypass National Correct Coding Initiative (NCCI) edits.
4. Modifier 76 - Repeat Procedure by Same Physician: If the procedure needs to be repeated by the same physician, this modifier is used to indicate that the same procedure was performed more than once on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: Similar to Modifier 76, but used when the repeat procedure is performed by a different physician.
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: This is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
8. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier indicates their involvement.
9. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon is required for a minimal portion of the procedure.
10. 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.
11. Modifier 99 - Multiple Modifiers: When more than four modifiers are necessary to describe the service, this modifier indicates that multiple modifiers are being used.
Each modifier serves a specific purpose and should be used in accordance with the guidelines provided by the American Medical Association (AMA) and payer-specific policies to ensure accurate billing and reimbursement.
The CPT code 60280, which involves the removal of a thyroid duct lesion, is indeed reimbursed by Medicare, provided that it meets the necessary coverage criteria and is deemed medically necessary. Reimbursement for this code is determined by the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B.
However, it's important to note that the reimbursement can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting specific guidelines within their jurisdiction, which can influence the final reimbursement amount for CPT code 60280. Healthcare providers should consult the MPFS and their respective MAC for the most accurate and up-to-date information regarding reimbursement for this procedure.
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