CPT code 28344 is a medical billing code used to describe the repair of extra toe(s) during a surgical procedure.
CPT code 28344 is used to describe the surgical procedure for repairing extra toe(s). This code specifically indicates that a healthcare provider has performed a corrective operation to address the presence of additional toes, which may involve removing or reconstructing the extra digit to restore normal foot function and appearance.
When billing for CPT code 28344 (Repair extra toe(s)), 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, including the repair of extra toes.
3. Modifier 59 - Distinct Procedural Service: This modifier is appropriate when the procedure is performed separately from other procedures on the same day, indicating that it is not a routine part of another service.
4. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated on the same day by the same physician.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is applicable if a patient requires a return to the operating room for complications related to the initial procedure.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier should be used if a different procedure is performed by the same physician during the postoperative period of the initial procedure.
7. Modifier LT - Left Side: Use this modifier to specify that the procedure was performed on the left foot.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right foot.
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 evaluation and management service is provided during the postoperative period unrelated to the initial procedure.
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 28344 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides detailed information on the reimbursement rates for various CPT codes, while the MACs are responsible for processing Medicare claims and can offer region-specific guidance on coverage and reimbursement.
Always consult these resources to ensure accurate and up-to-date information regarding the reimbursement status of CPT code 28344.
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