CPT Code 28285
CPT code 28285 is a medical billing code used for the surgical repair of a hammertoe, helping healthcare providers accurately document procedures.
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What is CPT Code 28285
CPT code 28285 is for the surgical repair of a hammertoe, a condition where one or more toes are bent at the middle joint, causing them to resemble a hammer. This procedure typically involves correcting the toe's position, which may include releasing tight tendons or ligaments, and can also involve the use of implants or other techniques to restore normal alignment and function.
Does CPT 28285 Need a Modifier?
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CPT Code 28285 Medicare Reimbursement
The CPT code 28285 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable coverage limitations, healthcare providers should consult the MPFS, which provides detailed information on the payment rates for services covered by Medicare.
Additionally, it is essential to verify with the local Medicare Administrative Contractor (MAC) for any region-specific policies or additional documentation requirements that may affect reimbursement. MACs are responsible for processing Medicare claims and can provide further guidance on whether CPT code 28285 is reimbursed in your specific jurisdiction.
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