How To Use CPT Code 28043

CPT 28043 describes the excision of a soft tissue tumor from the foot or toe, specifically from the subcutaneous layer, that is less than 1.5 cm in size. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28043?

CPT 28043 is used to describe the excision of a soft tissue tumor from the foot or toe, specifically from the subcutaneous layer, that is less than 1.5 cm in size. This code is used when a healthcare provider removes an abnormal mass located immediately below the skin of the foot or toe. The excised specimen is then sent to a laboratory for analysis to determine its nature.

2. Official Description

The official description of CPT code 28043 is: ‘Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate anesthesia and prepping the area.
2. An incision is made over the soft tissue tumor located below the skin of the foot or toe.
3. The healthcare provider completely excises the tumor along with its margins.
4. The excised specimen is sent to a laboratory for analysis to determine its nature.
5. The area is irrigated, checked for bleeding, and any instruments are removed.
6. The incision is closed.

4. Qualifying circumstances

CPT 28043 is used for the excision of a soft tissue tumor from the foot or toe that is located in the subcutaneous layer and is less than 1.5 cm in size. The procedure must be performed by a healthcare provider and the patient must meet the criteria for the excision of a soft tissue tumor.

5. When to use CPT code 28043

CPT code 28043 should be used when a healthcare provider performs the excision of a soft tissue tumor from the foot or toe that is located in the subcutaneous layer and is less than 1.5 cm in size. This code should not be used for excisions of tumors in other locations or for tumors larger than 1.5 cm.

6. Documentation requirements

To support a claim for CPT code 28043, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for excision of the soft tissue tumor
• Size and location of the tumor
• Details of the procedure, including the incision, excision, and closure
• Submission of the excised specimen to a laboratory for analysis
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 28043, ensure that the excision is performed on a soft tissue tumor located in the subcutaneous layer of the foot or toe that is less than 1.5 cm in size. Follow the appropriate coding guidelines and ensure accurate documentation to support the claim. It is important to note that CPT code 28043 should not be reported with other codes unless additional procedures or complications arise during the excision.

8. Historical information

CPT code 28043 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2010, where the description was modified to specify the excision of a soft tissue tumor from the foot.

9. Examples

1. A podiatrist performing the excision of a 1 cm soft tissue tumor located in the subcutaneous layer of a patient’s foot.
2. An orthopedic surgeon removing a 1.2 cm soft tissue tumor from the subcutaneous layer of a patient’s toe.
3. A dermatologist excising a 1.4 cm soft tissue tumor from the subcutaneous layer of a patient’s foot.
4. A plastic surgeon performing the excision of a 1.3 cm soft tissue tumor located in the subcutaneous layer of a patient’s toe.
5. An oncologist removing a 1.1 cm soft tissue tumor from the subcutaneous layer of a patient’s foot.
6. A general surgeon excising a 1.5 cm soft tissue tumor from the subcutaneous layer of a patient’s toe.
7. A podiatrist performing the excision of a 1.4 cm soft tissue tumor located in the subcutaneous layer of a patient’s foot.
8. An orthopedic surgeon removing a 1.2 cm soft tissue tumor from the subcutaneous layer of a patient’s toe.
9. A dermatologist excising a 1.3 cm soft tissue tumor from the subcutaneous layer of a patient’s foot.
10. A plastic surgeon performing the excision of a 1.1 cm soft tissue tumor located in the subcutaneous layer of a patient’s toe.