CPT code 28660 is used to describe the treatment of a dislocated toe, detailing the specific procedure performed by healthcare providers.
CPT code 28660 is used to describe the procedure for treating a dislocation of the toe. This code specifically refers to the manipulation and reduction of the dislocated joint in the toe, which may involve realigning the bones to restore normal function and alleviate pain.
When billing for the CPT code 28660, which pertains to the treatment of a toe 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 toes.
2. Modifier 51 - Multiple Procedures
Indicates that multiple procedures were performed during the same session.
3. Modifier 59 - Distinct Procedural Service
Used to indicate that the procedure is distinct or independent from other services performed on the same day.
4. Modifier LT - Left Side
Indicates that the procedure was performed on the left toe.
5. Modifier RT - Right Side
Indicates that the procedure was performed on the right toe.
6. Modifier 76 - Repeat Procedure or Service by Same Physician
Used when the procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician
Indicates that the procedure was repeated by a different physician on the same day.
8. Modifier 22 - Increased Procedural Services
Used when the procedure required significantly more work than typically required.
9. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period
Indicates that an unrelated E/M service was provided during the postoperative period.
10. Modifier 25 - Significant, Separately Identifiable E/M Service by the Same Physician on the Same Day
Used when a significant E/M service is performed on the same day as the procedure.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements. It is essential for healthcare providers to select the appropriate modifiers based on the specific circumstances of the treatment to avoid claim denials and ensure proper reimbursement.
The CPT code 28660 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 28660, and can be accessed through the Centers for Medicare & Medicaid Services (CMS) website.
Additionally, your MAC can offer localized guidance and confirm whether CPT code 28660 is covered under Medicare in your specific region.
Always ensure to check these resources for the most accurate and up-to-date information.
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