CPT code 28285 is a medical billing code used for the surgical repair of a hammertoe, helping healthcare providers accurately document procedures.
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.
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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.
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. With the ability to identify discrepancies for specific codes like 28285, you can ensure that your practice is receiving the full reimbursement it deserves. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
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