How To Use CPT Code 28005

CPT 28005 describes the procedure of incising the bone cortex in the foot to treat an infection or abscess. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28005?

CPT 28005 is used to describe a specific procedure performed by a healthcare provider to treat an infection or abscess in a bone of the foot. The provider makes an incision in the skin over the infected bone, accesses the bone by incising through the soft tissue, and removes the infected portion of the bone. The area is then washed with an antibiotic solution, and the wound is closed by suturing the soft tissue layers.

2. Official Description

The official description of CPT code 28005 is: ‘Incision, bone cortex (eg, osteomyelitis or bone abscess), foot.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made in the skin over the infected bone.
3. The provider incises through the soft tissue to gain access to the infected bone.
4. The periosteum, the outer membrane of the bone, is incised and reflected.
5. The infected portion of the bone is debrided or scraped away.
6. The area is washed with an antibiotic solution to prevent further infection.
7. The periosteum is placed back in its original position over the bone.
8. The wound is closed by suturing the soft tissue layers.

4. Qualifying circumstances

CPT 28005 is performed when a patient has an infection or abscess in a bone of the foot that requires treatment. The procedure is typically performed by a healthcare provider who is experienced in bone surgery. The patient must meet the criteria for the procedure, such as having a diagnosed infection or abscess in the bone cortex of the foot.

5. When to use CPT code 28005

CPT code 28005 should be used when a healthcare provider performs an incision in the bone cortex of the foot to treat an infection or abscess. It is important to accurately document the diagnosis and medical necessity for the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 28005, the healthcare provider must document the following information:

• Patient’s diagnosis of an infection or abscess in the bone cortex of the foot
• Details of the procedure, including the incision site and size
• Extent of the infection or abscess and the portion of the bone removed
• Use of anesthesia and any complications or additional procedures performed
• Post-operative care instructions and follow-up plans
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 28005, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the diagnosis and medical necessity for the procedure. CPT code 28005 should not be reported with other codes unless additional procedures were performed during the same session.

8. Historical information

CPT 28005 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A podiatrist performing an incision in the bone cortex of the foot to treat osteomyelitis.
2. An orthopedic surgeon making an incision in the bone cortex of the foot to drain an abscess.
3. A foot and ankle specialist performing an incision in the bone cortex of the foot to remove infected bone tissue.
4. A trauma surgeon incising the bone cortex of the foot to treat a bone abscess caused by an injury.
5. A reconstructive surgeon making an incision in the bone cortex of the foot to debride and decompress the bone marrow cavity.
6. A pediatric orthopedic surgeon performing an incision in the bone cortex of the foot to explore and drain an infected bone.
7. A sports medicine physician making an incision in the bone cortex of the foot to treat an infection in a professional athlete.
8. An infectious disease specialist performing an incision in the bone cortex of the foot to remove infected bone tissue and administer antibiotic treatment.
9. A plastic surgeon making an incision in the bone cortex of the foot to treat an abscess caused by a previous surgical procedure.
10. An interventional radiologist performing an incision in the bone cortex of the foot to drain an abscess under imaging guidance.