CPT code 28555 is used to describe the surgical repair of a dislocated foot, detailing the specific procedure for billing and documentation.
CPT code 28555 is used to describe the surgical procedure for repairing a dislocation of the foot. This code specifically indicates that the healthcare provider has performed a surgical intervention to correct the dislocation, which may involve realigning the bones and stabilizing the joint to restore normal function and alleviate pain.
When billing for the CPT code 28555, which pertains to the repair of a foot dislocation, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers that could be used, along with the reasons for their application:
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 procedure.
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 or Service by Same Physician or Other Qualified Health Care Professional
Used when the same procedure is repeated on the same day by the same provider.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional 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 or Other Qualified Health Care Professional During the Postoperative Period
Used when a procedure is performed that is unrelated to the original procedure 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 AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery
Used when a non-physician provider assists in the 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 28555 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, including 28555. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement.
Therefore, it is advisable to consult both the MPFS and your local MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 28555.
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. For instance, with CPT code 28555, you can ensure that every dollar is accounted for. Schedule a demo today to see how RevFind can help you maximize your reimbursements and improve your financial performance.
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
