CPT code 28041 is for excising a foot or toe tumor that measures 1.5 cm, detailing the specific procedure for billing and documentation.
CPT code 28041 is used to describe the excision of a tumor from the foot or toe that measures 1.5 centimeters or greater. This procedure involves the surgical removal of the tumor along with some surrounding tissue to ensure complete excision and minimize the risk of recurrence.
When billing for CPT code 28041, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used with this code, along with the reasons for their use:
1. -50: Bilateral Procedure
Used when the procedure is performed on both feet.
2. -RT: Right Side
Indicates that the procedure was performed on the right foot.
3. -LT: Left Side
Indicates that the procedure was performed on the left foot.
4. -59: Distinct Procedural Service
Used to indicate that the procedure is separate and distinct from other services performed on the same day.
5. -76: Repeat Procedure by Same Physician
Used when the same procedure is performed more than once by the same physician on the same day.
6. -77: Repeat Procedure by Another Physician
Indicates that the same procedure was performed by a different physician on the same day.
7. -22: Increased Procedural Services
Used when the procedure performed is more complex than usual, requiring additional effort or time.
8. -52: Reduced Services
Indicates that the service provided was less than the full procedure.
9. -53: Discontinued Procedure
Used when the procedure was started but not completed due to extenuating circumstances.
10. -GC: Graduate Medical Education (GME) Modifier
Indicates that the service was performed by a resident under the supervision of a teaching physician.
11. -KX: Requirements Met
Used to indicate that the provider has met the requirements for coverage of the service.
12. -AS: Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services
Indicates that the service was performed by a non-physician practitioner.
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.
The CPT code 28041 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates. Additionally, it is advisable to consult with your local Medicare Administrative Contractor (MAC) to confirm any regional variations or specific guidelines that may affect reimbursement for CPT code 28041.
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