How To Use CPT Code 28011

CPT 28011 describes a specific surgical procedure performed on the foot and toes. 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 28011?

CPT 28011 is a code used to describe a surgical procedure performed on the foot and toes. It specifically refers to a percutaneous tenotomy, which involves the incision or division of multiple tendons in a toe through a small incision in the skin. This procedure is typically done to correct deformities like hammer toe.

2. Official Description

The official description of CPT code 28011 is: ‘Tenotomy, percutaneous, toe; multiple tendons.’ This code is used when the provider performs a percutaneous tenotomy on multiple tendons in a toe through a small incision in the skin.

3. Procedure

1. In this procedure, the provider begins by making a small incision in the skin of the toe over the tendons that need to be divided.
2. Once the incision is made, the provider inserts a small cutting tool through the incision.
3. Using the cutting tool, the provider then incises or divides the tendons to lengthen them.
4. This lengthening of the tendons allows the muscles to return to their normal length, which in turn straightens the joint and corrects the deformity.
5. After the tenotomy is performed, the provider ensures hemostasis at the surgical site and closes the wound by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 28011 is used when a percutaneous tenotomy is performed on multiple tendons in a toe to correct a deformity like hammer toe. This procedure is typically done to address congenital or acquired shortening of a muscle that causes the toe to bend or curl. It is important to note that CPT 28011 is specifically for percutaneous tenotomy and should not be used for open tenotomy procedures.

5. When to use CPT code 28011

CPT code 28011 should be used when the provider performs a percutaneous tenotomy on multiple tendons in a toe. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves the division of a single tendon, CPT code 28010 should be used instead.

6. Documentation requirements

To support a claim for CPT 28011, the provider must document the following information:

• The specific toe and tendons involved in the procedure
• A description of the deformity being corrected
• The approach used (percutaneous)
• The date of the procedure
• Details of the procedure, including the incision, division of tendons, and closure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 28011, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should use the appropriate code based on the number of tendons being divided. It is also important to follow any additional guidelines provided by the payer or coding guidelines. It is recommended to review the specific billing guidelines for CPT 28011 to ensure accurate reporting and reimbursement.

8. Historical information

CPT 28011 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A podiatrist performing a percutaneous tenotomy on multiple tendons in a patient’s hammer toe to correct the deformity.
2. An orthopedic surgeon using a percutaneous tenotomy to lengthen the tendons in a patient’s toe, addressing their congenital shortening.
3. A foot and ankle specialist performing a percutaneous tenotomy on multiple tendons in a patient’s toe to correct the acquired deformity caused by an injury.
4. A pediatric orthopedic surgeon using a percutaneous tenotomy to address the congenital shortening of tendons in a child’s toe, correcting their hammer toe.
5. A podiatric surgeon performing a percutaneous tenotomy on multiple tendons in a patient’s toe to correct the deformity caused by arthritis.
6. An orthopedic specialist using a percutaneous tenotomy to lengthen the tendons in a patient’s toe, addressing their acquired shortening due to muscle imbalance.
7. A foot and ankle surgeon performing a percutaneous tenotomy on multiple tendons in a patient’s toe to correct the deformity caused by a neuromuscular condition.
8. A podiatrist using a percutaneous tenotomy to address the congenital shortening of tendons in a patient’s toe, correcting their hammer toe.
9. An orthopedic surgeon performing a percutaneous tenotomy on multiple tendons in a patient’s toe to correct the deformity caused by an injury.
10. A foot and ankle specialist using a percutaneous tenotomy to lengthen the tendons in a patient’s toe, addressing their acquired shortening due to muscle imbalance.