CPT code 28110 is for the partial removal of a metatarsal bone in the foot, used for billing and documentation in healthcare services.
CPT code 28110 is the code used to describe the surgical procedure involving the partial removal of a metatarsal bone in the foot. This procedure is typically performed to alleviate pain or correct deformities associated with conditions such as bunions or other foot-related issues.
When billing for the CPT code 28110, which pertains to the partial removal of a metatarsal, 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 LT - Left Side
Indicates that the procedure was performed on the left foot.
5. Modifier RT - Right Side
Indicates that the procedure was performed on the right foot.
6. Modifier 78 - Return to the Operating Room for a Related Procedure
Used if the patient requires a return to the operating room for a related procedure within the global period.
7. 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.
8. Modifier 22 - Increased Procedural Services
Used when the procedure required significantly more work than typically required.
9. Modifier 26 - Professional Component
Indicates that only the professional component of the service is being billed.
10. Modifier TC - Technical Component
Indicates that only the technical component of the service is being billed.
It is essential to select the appropriate modifier(s) based on the specific details of the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 28110 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable guidelines, healthcare providers should refer to the MPFS.
Additionally, it is important to consult with the relevant Medicare Administrative Contractor (MAC) for your region, as they can provide detailed information on coverage policies, local coverage determinations (LCDs), and any additional documentation requirements that may apply to CPT code 28110.
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