CPT code 28737 is for the surgical revision of foot bones, used to describe a specific procedure in healthcare billing and documentation.
CPT code 28737 is used to describe a surgical procedure involving the revision of foot bones. This code indicates that a healthcare provider is performing a corrective operation on the bones of the foot, typically to address issues such as malalignment, previous surgical complications, or other deformities. The procedure may involve realigning, reshaping, or stabilizing the bones to restore proper function and alleviate pain.
When billing for the CPT code 28737 (Revision of foot bones), 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 appropriate 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: This modifier should be used if the revision is part of a staged procedure or if it is a subsequent procedure related to a previous surgery.
4. Modifier 59 - Distinct Procedural Service: This modifier is applicable when the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if 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 Following Initial Procedure for a Related Procedure: This modifier is relevant if the patient requires an unplanned return to the operating room for a related procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if a procedure unrelated to the original surgery is performed during the postoperative period.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right foot.
9. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left foot.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
It is essential to choose the appropriate modifier(s) based on the specific details of the procedure to ensure accurate billing and compliance with payer requirements.
CPT code 28737 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services and procedures covered by Medicare, and it is updated annually to reflect changes in policy and reimbursement rates.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for CPT codes. Therefore, while CPT code 28737 is generally reimbursed by Medicare, healthcare providers should consult the MPFS and their respective MAC for the most accurate and up-to-date information regarding reimbursement rates and any specific coverage criteria.
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