How To Use CPT Code 28124

CPT 28124 refers to a partial excision of the infected portion of the phalanx of the toe using specific techniques. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 28124 procedures.

1. What is CPT 28124?

CPT 28124 is a medical procedure code used to describe the partial excision of the infected portion of the phalanx of the toe using specific techniques such as craterization, saucerization, sequestrectomy, or diaphysectomy. This code is utilized by medical professionals to accurately document and bill for this specific procedure.

2. 28124 CPT code description

The official description of CPT code 28124 is: “Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision on the affected toe.
3. Soft tissues and tendons are dissected, and the infected bone of the phalanx is identified.
4. The infected portion of the bone is partially excised using one of the specified techniques (craterization, saucerization, sequestrectomy, or diaphysectomy).
5. The cavity left in the bone may be filled using a bone graft.
6. The wound is closed in layers.

4. Qualifying circumstances

Patients eligible to receive CPT 28124 services are those diagnosed with conditions such as osteomyelitis or bossing affecting the phalanx of the toe. The provider must determine that a partial excision of the infected portion of the bone is necessary for the patient’s treatment and recovery.

5. When to use CPT code 28124

It is appropriate to bill the 28124 CPT code when the provider performs a partial excision of the infected portion of the phalanx of the toe using one of the specified techniques (craterization, saucerization, sequestrectomy, or diaphysectomy) to treat conditions such as osteomyelitis or bossing.

6. Documentation requirements

To support a claim for CPT 28124, the following information should be documented:

• Patient’s medical history and diagnosis, including the specific condition affecting the phalanx of the toe.
• Physical examination findings and any relevant imaging studies.
• Provider’s decision to perform the partial excision procedure and the chosen technique.
• Detailed description of the procedure, including the steps taken and any complications encountered.
• Postoperative care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 28124, it is essential to follow the specific guidelines and rules set forth by the payer. Ensure that the documentation supports the medical necessity of the procedure and that all required information is included in the claim. Additionally, be aware of any relevant modifiers or additional codes that may apply to the specific case.

8. Historical information

CPT 28124 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the descriptor since its addition.

9. Similar codes to CPT 28124

Five similar codes to CPT 28124 and how they differentiate are:

• CPT 28120: Partial excision of the infected portion of the talus or calcaneus bone using specified techniques.
• CPT 28122: Partial excision of the infected portion of the tarsal or metatarsal bone, except talus or calcaneus, using specified techniques.
• CPT 28125: Partial excision of the infected portion of the phalanx of the finger using specified techniques.
• CPT 28126: Partial excision of the infected portion of the metacarpal bone using specified techniques.
• CPT 28127: Partial excision of the infected portion of the carpal bone using specified techniques.

10. Examples

1. A patient with osteomyelitis in the phalanx of the big toe undergoes a partial excision using the craterization technique.
2. A patient with bossing in the phalanx of the second toe undergoes a partial excision using the saucerization technique.
3. A patient with a chronic infection in the phalanx of the third toe undergoes a partial excision using the sequestrectomy technique.
4. A patient with a non-healing wound in the phalanx of the fourth toe undergoes a partial excision using the diaphysectomy technique.
5. A patient with a history of recurrent infections in the phalanx of the fifth toe undergoes a partial excision using the craterization technique.
6. A patient with a bone deformity in the phalanx of the big toe undergoes a partial excision using the saucerization technique.
7. A patient with a non-healing ulcer in the phalanx of the second toe undergoes a partial excision using the sequestrectomy technique.
8. A patient with a bone abscess in the phalanx of the third toe undergoes a partial excision using the diaphysectomy technique.
9. A patient with a history of failed conservative treatment for osteomyelitis in the phalanx of the fourth toe undergoes a partial excision using the craterization technique.
10. A patient with a chronic infection and bone deformity in the phalanx of the fifth toe undergoes a partial excision using the saucerization technique.