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Question: What is the correct laterality modifier to bill with 28122? I first billed it with a T modifier and got denied. I then tried billing with both the RT (as the procedure was performed on the patient’s right foot) and the T modifier and got denied again. Please help!

RCI Subscriber

Answer: CPT^® code 28122 (Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus), as the descriptor states, is for partial excision of bone of the tarsal or metatarsal. The T modifiers are for toes, and because the metatarsal is not considered to be a toe, this modifier would be incorrect.

For 28122, you should use the RT/LT (Right side/Left side) laterality modifiers only. If your podiatrist performs procedures on multiple metatarsals on the same foot, you should then append modifier 59 (Distinct procedural service) to one of the CPT^{®&²Ô²ú²õ±è;}codes, and an RT/LT modifier as necessary to the others depending on the preference of the payer.

Lindsey Bush, BA, MA, CPC, Development Editor, AAPC