betsycpcp
Networker
A hospital has billed 27427 without a device code even though it's listed as a device dependent procedure, because no device was used. The op report says they did a quad turndown where part of the patient's own quadriceps tendon was used for repair of the MPFL. The hospital tried billing the a CG modifier to bypass the device edit, but it didn't work. This was not a Medicare claim, it's workers' comp, but they use Medicare's OPPS guidelines. The claims processing manual says in Chapter 4, section 61.2 that modifier CG can be used for certain procedures - but I've never been able to find out which procedures. Does anyone know where there is a list, or if 27427 should be payable with the CG modifier?
Thanks.
Thanks.