CPT code 28080 is for the removal of a lesion on the foot, detailing the specific procedure for accurate billing and documentation.
CPT code 28080 is the code used for the surgical removal of a lesion located on the foot. This procedure typically involves excising a growth or abnormal tissue from the foot, which may be necessary for diagnostic purposes or to alleviate discomfort. The code encompasses the complete removal of the lesion, including any necessary closure of the wound afterward.
When billing for the CPT code 28080, which pertains to the removal of a foot lesion, 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. -50: Bilateral Procedure
Used when the procedure is performed on both feet.
2. -51: Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. -59: Distinct Procedural Service
Used to indicate that the procedure is distinct or independent from other services performed on the same day.
4. -76: Repeat Procedure by Same Physician
Indicates that the same procedure was performed again by the same physician on the same day.
5. -78: Unplanned Return to the Operating/Procedure Room
Used when a patient returns to the operating room for a related procedure within the global period.
6. -79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
7. -RT: Right Side
Used to specify that the procedure was performed on the right foot.
8. -LT: Left Side
Used to specify that the procedure was performed on the left foot.
9. -22: Increased Procedural Services
Indicates that the work required to provide the service was substantially greater than typically required.
10. -27: Multiple Outpatient Hospital E/M Encounters on the Same Date
Used when multiple evaluation and management services are provided on the same day.
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 28080 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 payment rates. Additionally, reimbursement can vary based on the region and the specific Medicare Administrative Contractor (MAC) overseeing the claims in that area. Therefore, healthcare providers should consult their local MAC for precise information regarding the reimbursement rates and any specific billing requirements for CPT code 28080.
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 RevFind, you can identify discrepancies for specific CPT code 28080, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can streamline your RCM process and improve your bottom line.
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