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Wiki Device intensive procedure 27427 with CG modifier?

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betsycpcp

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Cincinnati, OH
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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.
 
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