CPT Code 67027

CPT code 67027 is used for billing the implantation of an intraocular drug delivery system.

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What is CPT Code 67027

CPT code 67027 is used to describe the surgical procedure involving the implantation of an intraocular drug delivery system into the eye. This code is specifically utilized when a device is implanted to deliver medication directly into the eye over a set period, often used for treating conditions like retinal disease, macular degeneration, or diabetic macular edema. The procedure includes the implantation but does not include the supply of the drug itself.

Does CPT 67027 Need a Modifier?

For CPT code 67027, which involves the implantation of an intraocular drug delivery system, several modifiers may be applicable depending on the specific circumstances of the procedure. Here’s an ordered list of potential modifiers and the reasons for their use:

1. -RT (Right Side) and -LT (Left Side): These modifiers are used to indicate which eye received the implant. Since the procedure is specific to the eyes, specifying the side is crucial for accurate billing and medical records.

2. -50 (Bilateral Procedure): If the implant eye drug system is placed in both eyes during the same operative session, this modifier should be used to indicate a bilateral procedure.

3. -51 (Multiple Procedures): This modifier is used if multiple procedures are performed during the same surgical session. It may be applicable if the implantation is performed alongside other distinct procedures.

4. -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. This could be relevant if the implantation is performed in conjunction with other services that are not normally reported together.

5. -79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): If the implantation occurs during the postoperative period of another unrelated procedure and is performed by the same physician, this modifier would be necessary.

6. -24 (Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period): If an evaluation and management service is performed during the postoperative period of the implant procedure and is unrelated to the original procedure, this modifier would be used.

Each of these modifiers serves to provide additional details that can affect reimbursement and are essential for avoiding billing errors and ensuring compliance with payer policies.

CPT Code 67027 Medicare Reimbursement

CPT code 67027, which pertains to the implantation of an intraocular drug delivery system, is generally reimbursed by Medicare. However, the specific reimbursement amount can vary based on geographic location, the facility where the procedure is performed, and other factors. To determine the exact reimbursement rate, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website or through your local Medicare Administrative Contractor (MAC). This will provide the most accurate and up-to-date information regarding reimbursement for CPT code 67027.

Are You Being Underpaid for 67027 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to read your contracts and identify discrepancies down to specific CPT codes, such as 67027 for implanting an eye drug system, RevFind ensures that each claim is reimbursed correctly according to your payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to for every procedure billed.

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