CPT code 28039 is used to describe the excision of a foot or toe tumor measuring 1.5 cm or less.
CPT code 28039 is used to describe the excision of a tumor from the foot or toe that measures 1.5 centimeters or less. This procedure involves the surgical removal of the tumor, which may be necessary for both diagnostic and therapeutic purposes. The code specifically indicates that the tumor is located in the foot or toe and provides a size reference for the excised lesion.
When billing for CPT code 28039, which pertains to excision of a foot or toe tumor, the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both feet or toes.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate when multiple procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used to indicate that a procedure is distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the same procedure is performed more than once by the same physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient requires a return to the operating room for a related procedure within the global period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a different procedure is performed by the same physician during the postoperative period of the original procedure.
7. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left foot or toe.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right foot or toe.
9. Modifier 22 - Increased Procedural Services: This modifier can be used if the procedure required significantly more work than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is used when a patient has multiple encounters on the same date of service.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 28039 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable coverage limitations, healthcare providers should consult the MPFS. Additionally, it is important to verify with the relevant Medicare Administrative Contractor (MAC) for any local coverage determinations or specific guidelines that may affect reimbursement for CPT code 28039.
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