CPT code 28320 is for the surgical repair of foot bones, detailing the specific procedure for accurate billing and documentation in healthcare.
CPT code 28320 is for the surgical repair of foot bones. This procedure typically involves correcting fractures or deformities in the bones of the foot, ensuring proper alignment and function. It may include the use of hardware, such as screws or plates, to stabilize the bones during the healing process.
When billing for the CPT code 28320, 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 is applicable if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional: Use this modifier if the procedure is part of a staged treatment plan.
4. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is performed separately from other procedures on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated by the same provider on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure: This modifier is used if a patient requires a return to the operating room for a related procedure within the global period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is applicable if a different procedure is performed during the postoperative period of the initial procedure.
8. Modifier LT - Left Side: Use this modifier to specify that the procedure was performed on the left foot.
9. Modifier RT - Right Side: Use this modifier to specify that the procedure was performed on the right foot.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if 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 28320 is reimbursed by Medicare, but the specifics of reimbursement can vary based on several factors. To determine if this code is reimbursed under the Medicare Physician Fee Schedule (MPFS), healthcare providers should consult the MPFS database, which outlines the payment rates for services covered by Medicare.
Additionally, it is essential to check with the relevant Medicare Administrative Contractor (MAC) for your region, as MACs are responsible for processing Medicare claims and can provide detailed information on coverage policies and any local coverage determinations (LCDs) that may affect reimbursement.
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 RevFind, you can identify discrepancies for specific codes like 28320, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can optimize your revenue recovery process.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
