CPT code 28107 is used for the removal or grafting of a lesion on the foot, helping to standardize billing and documentation in healthcare.
CPT code 28107 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 includes the additional step of grafting to ensure proper healing and restoration of the foot's structure.
When billing for the CPT code 28107, which pertains to the removal or grafting of a foot lesion, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used, along with the reasons for their application:
1. Modifier 50 - Bilateral Procedure
Used when the procedure is performed on both feet.
2. Modifier 51 - Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. Modifier 59 - Distinct Procedural Service
Used to indicate that the procedure was distinct or independent from other services performed on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician
Indicates that the same procedure was performed again by the same physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room
Used when a 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
Indicates that a procedure was performed that is unrelated to the original procedure during the postoperative period.
7. Modifier LT - Left Side
Used to specify that the procedure was performed on the left foot.
8. Modifier RT - Right Side
Used to specify that the procedure was performed on the right foot.
9. Modifier 22 - Increased Procedural Services
Indicates that the procedure was more complex than usual, warranting additional reimbursement.
10. Modifier 27 - Multiple Encounters on the Same Date
Used when a patient has multiple encounters on the same date of service.
It is essential for healthcare providers to select the appropriate modifiers based on the specific details of the procedure performed to ensure accurate billing and reimbursement.
The CPT code 28107 is reimbursed by Medicare, but it is essential to verify the specific details through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides a comprehensive list of services covered by Medicare, including the reimbursement rates for each CPT code. Additionally, MACs administer Medicare claims and can offer region-specific information regarding coverage and reimbursement policies. Therefore, while CPT code 28107 is generally reimbursed by Medicare, consulting the MPFS and your MAC will provide the most accurate and up-to-date information.
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 28107, ensuring you receive the full reimbursement you deserve. Schedule a demo today to see how RevFind can streamline your revenue processes and improve your bottom line.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
