CPT code 28220 is a medical billing code used for the release of a foot tendon procedure in healthcare.
CPT code 28220 is for the surgical procedure involving the release of a tendon in the foot. This procedure is typically performed to alleviate pain or restore function when a tendon is tight or constricted, often due to conditions such as tendonitis or other injuries. The goal of the release is to improve mobility and reduce discomfort in the affected area.
When billing for the CPT code 28220, which pertains to the release of a foot tendon, 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 is appropriate when the procedure is performed on a separate site or is distinct from other services provided on the same day.
4. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left foot.
5. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right foot.
6. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
7. 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 unrelated E/M service is provided during the postoperative period.
8. Modifier 78 - Return to the Operating Room for a Related Procedure During the Postoperative Period: Use this modifier if a related procedure is performed during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier is appropriate for unrelated procedures performed during the postoperative period.
10. Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date: This modifier can be used if multiple outpatient E/M encounters occur on the same day.
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 28220 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment amounts.
Additionally, reimbursement for CPT code 28220 may vary depending on the region, as Medicare Administrative Contractors (MACs) have the authority to make local coverage determinations. Therefore, it is advisable to consult the relevant MAC for your area to confirm the reimbursement details for CPT code 28220.
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