CPT code 28140 is for the surgical removal of a metatarsal bone in the foot, often due to injury or deformity.
CPT code 28140 is the procedure for the removal of a metatarsal bone, which is one of the long bones in the foot. This code is used when a healthcare provider performs a surgical procedure to excise or remove a metatarsal due to conditions such as fractures, tumors, or severe deformities. The procedure typically involves making an incision in the foot, accessing the metatarsal, and carefully removing it to alleviate pain or restore function.
When billing for the CPT code 28140, which pertains to the removal of a metatarsal, 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 is applicable if multiple surgical procedures are performed during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used when the procedure is distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side: Use this modifier to indicate that the procedure was performed on the left foot.
5. Modifier RT - Right Side: Use this modifier to indicate that the procedure was performed on the right foot.
6. Modifier 78 - Return to the Operating Room for a Related Procedure: This modifier is appropriate 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 or Other Qualified Health Care Professional During the Postoperative Period: This modifier is used if a different procedure is performed during the postoperative period that is unrelated to the original procedure.
8. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period: This modifier is applicable if an evaluation and management service is provided during the postoperative period that is unrelated to the surgery.
10. Modifier 27 - Multiple Encounters on the Same Date: This modifier can be used when a patient has multiple encounters on the same day for different services.
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 28140 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 28140. Additionally, your MAC can offer localized guidance and any specific coverage criteria that may apply.
Always ensure to check these resources to confirm the most current reimbursement details for CPT code 28140.
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