CPT code 28585 is used to describe the surgical repair of a dislocated foot, detailing the specific procedure performed.
CPT code 28585 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 restore the normal alignment and function of the bones in the foot that have been displaced due to a dislocation.
When billing for the CPT code 28585, 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:
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 if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure: This modifier is appropriate if the procedure is a staged procedure or if it is related to a previous procedure performed during the postoperative period.
4. Modifier 78 - Unplanned Return to the Operating Room: Use this modifier if the patient requires an unplanned return to the operating room for a related procedure within the postoperative period.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is applicable if a procedure unrelated to the original procedure is performed by the same physician during the postoperative period.
6. Modifier 22 - Increased Procedural Services: This modifier can be used if the procedure required significantly more work than typically required.
7. Modifier 26 - Professional Component: Use this modifier if billing separately for the professional component of the service when applicable.
8. Modifier TC - Technical Component: This modifier is used when billing for the technical component of the service separately, if applicable.
9. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier may be relevant if a repeat test is performed on the same day.
10. Modifier 99 - Multiple Modifiers: This modifier is used when more than one modifier is applicable to the procedure.
It is essential to evaluate the specific circumstances surrounding the procedure to determine which modifiers are appropriate for accurate billing and compliance.
The CPT code 28585 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, it is advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may apply to CPT code 28585. This ensures that you are fully compliant with Medicare's guidelines and can accurately anticipate reimbursement for the services provided.
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