CPT code 28102 is used for the removal or grafting of a lesion on the foot, helping healthcare providers bill for this specific procedure.
CPT code 28102 is used to describe the surgical procedure for the removal of a lesion on the foot, which may involve grafting tissue to repair the area after the lesion has been excised. This code indicates that the procedure is more complex than a simple excision, as it requires additional steps to ensure proper healing and restoration of the foot's structure.
When billing for the CPT code 28102, which pertains to the removal or grafting 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. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both feet.
2. Modifier 51 - Multiple Procedures: This modifier should be applied when multiple procedures are performed during the same session.
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 76 - Repeat Procedure by Same Physician: Use this modifier 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: This modifier is applicable 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 should be 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.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right foot.
9. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier is applicable when the patient has multiple encounters on the same date of service.
It is essential to select the appropriate modifiers based on the specific details of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 28102 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 28102. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement.
Therefore, it is advisable to consult both the MPFS and your local MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 28102.
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, including specific codes like 28102. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and optimize your reimbursement process. Don't leave money on the table—take the first step towards improved financial performance.
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