CPT code 28307 is for the surgical incision of a metatarsal bone in the foot, used for billing and documentation in healthcare.
CPT code 28307 is used to describe the surgical procedure involving the incision of a metatarsal bone in the foot. This code is typically applied when a healthcare provider performs an operation to access the metatarsal for various reasons, such as to treat a fracture, remove a bone spur, or address other conditions affecting the metatarsal.
When billing for CPT code 28307 (Incision of metatarsal), 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 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional
Used when the procedure is a staged procedure or a procedure related to a previous one.
4. Modifier 59 - Distinct Procedural Service
Indicates that the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician
Used when the same procedure is performed again by the same physician.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
Indicates an unplanned return to the operating room for a related procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Used when a procedure unrelated to the original procedure is performed during the postoperative period.
8. Modifier LT - Left Side
Indicates that the procedure was performed on the left foot.
9. Modifier RT - Right Side
Indicates that the procedure was performed on the right foot.
10. Modifier 22 - Increased Procedural Services
Used when the procedure required significantly more work than typically required.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements.
The CPT code 28307 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.
Additionally, reimbursement can vary based on the guidelines set forth by the Medicare Administrative Contractor (MAC) for your region.
Therefore, it is advisable to consult the MPFS and your local MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 28307.
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