CPT code 28192 is for the removal of a foreign body from the foot, helping healthcare providers accurately bill for this specific procedure.
CPT code 28192 is used to describe the procedure of removing a foreign body from the foot. This code specifically applies when a healthcare provider performs an intervention to extract an object that has become lodged in the foot tissue, which may include items like splinters, glass, or other debris. The procedure is typically performed to alleviate pain, prevent infection, and restore normal function to the affected area.
When billing for the CPT code 28192, which pertains to the removal of a foot foreign body, 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
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 is 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 to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and reimbursement.
The CPT code 28192 is reimbursed by Medicare, but it is essential to verify its specific reimbursement status through the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare.
Additionally, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 28192. Each MAC may have unique policies that influence how this code is processed and reimbursed.
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. For instance, with CPT code 28192, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
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