CPT CODES

CPT Code 28100

CPT code 28100 is for the removal of a lesion from the ankle or heel, detailing the specific procedure for billing and documentation purposes.

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What is CPT Code 28100

CPT code 28100 is for the surgical removal of a lesion located on the ankle or heel. This procedure typically involves excising a growth or abnormal tissue from the specified area, which may be necessary for diagnostic purposes or to alleviate discomfort.

Does CPT 28100 Need a Modifier?

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CPT Code 28100 Medicare Reimbursement

CPT code 28100 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates. To determine the exact reimbursement rate for CPT code 28100, healthcare providers should refer to the MPFS.

Additionally, Medicare Administrative Contractors (MACs) play a crucial role in processing claims and providing guidance on Medicare coverage policies. Each MAC may have localized policies that could affect the reimbursement of CPT code 28100. Therefore, it is advisable for healthcare providers to consult their respective MAC for any region-specific guidelines or additional documentation requirements that may impact the reimbursement process.

Are You Being Underpaid for 28100 CPT Code?

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 CPT code 28100 and ensure you are receiving the correct reimbursements. Schedule a demo today to see how RevFind can help you maximize your revenue.

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