CPT code 28002 is used to describe the treatment of a foot infection in healthcare billing and documentation.
CPT code 28002 is for the treatment of a foot infection. This code specifically refers to the surgical procedure involved in addressing infections that affect the soft tissues of the foot, which may include incision and drainage or other necessary interventions to manage the infection effectively.
When billing for CPT code 28002, which pertains to the treatment of a foot infection, 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 25 - Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure. This modifier is used when a patient receives an E/M service on the same day as the procedure.
2. Modifier 50 - Bilateral procedure. This modifier is used when the procedure is performed on both feet.
3. Modifier 59 - Distinct procedural service. This modifier indicates that the procedure is separate and distinct from other services performed on the same day.
4. Modifier LT - Left side. This modifier is used to specify that the procedure was performed on the left foot.
5. Modifier RT - Right side. This modifier is used to specify that the procedure was performed on the right foot.
6. Modifier 76 - Repeat procedure or service by the same physician or other qualified health care professional. This modifier is used when the same procedure is performed again on the same day.
7. Modifier 78 - Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period. This modifier is applicable if a complication arises that requires additional surgical intervention.
8. Modifier 79 - Unrelated procedure or service by the same physician during the postoperative period. This modifier is used if a different procedure is performed during the postoperative period of the initial procedure.
9. Modifier 91 - Repeat clinical diagnostic laboratory test. This modifier is used when a laboratory test is repeated on the same day for the same patient.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the treatment provided to ensure accurate billing and compliance with payer requirements.
The CPT code 28002 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the reimbursement rates and guidelines for services covered under Medicare.
Additionally, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may affect reimbursement for CPT code 28002.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. With the ability to identify discrepancies for specific codes like 28002, you can ensure that your practice is receiving the full reimbursement it deserves. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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