CPT code 28272 is for the release of a toe joint, indicating a specific surgical procedure performed on the toe.
CPT code 28272 is for the surgical procedure involving the release of a toe joint. This code specifically refers to the intervention performed on each toe joint to alleviate pain or improve function, typically due to conditions such as contractures or deformities. The procedure may involve cutting or loosening the surrounding tissues to restore normal movement and alignment of the toe.
When billing for CPT code 28272 (Release of toe joint each), 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: Use this modifier to indicate that the procedure is distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side: This modifier is used to specify that the procedure was performed on the left foot.
5. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right foot.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the same procedure is performed again by the same physician on the same day.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient requires a return to the operating room for a related procedure within the global period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a different procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
10. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: This modifier is appropriate if an unrelated evaluation and management service is provided during the postoperative period.
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 28272 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, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have localized policies and guidelines that affect payment. Therefore, healthcare providers should consult both the MPFS and their respective MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 28272.
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