How To Use CPT Code 28050

CPT 28050 describes the procedure of arthrotomy with biopsy on the intertarsal or tarsometatarsal joint. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28050?

CPT 28050 is used to describe a specific surgical procedure known as arthrotomy with biopsy. This procedure involves the opening of a joint in the foot, specifically the intertarsal or tarsometatarsal joint, to obtain a biopsy of the soft tissue for further analysis. It is typically performed by a healthcare provider who specializes in foot and ankle conditions.

2. Official Description

The official description of CPT code 28050 is: ‘Arthrotomy with biopsy; intertarsal or tarsometatarsal joint.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate anesthesia and sterilization of the surgical site.
2. An incision is made in the skin over the intertarsal or tarsometatarsal joint, followed by dissection through the subcutaneous tissue to reach the joint capsule.
3. The joint capsule is incised and opened, allowing the healthcare provider to explore the joint space and identify any abnormalities.
4. A biopsy of the joint tissue, such as synovial tissue, is then taken for further analysis.
5. The wound is irrigated with an antibiotic solution to prevent infection, and the layers of the incision are closed. In some cases, a drain may be left in place.

4. Qualifying circumstances

CPT 28050 is typically performed on patients who require a biopsy of the intertarsal or tarsometatarsal joint. This procedure is commonly used to investigate and diagnose conditions affecting these specific joints, such as arthritis or other inflammatory disorders. It is important to note that the procedure should only be performed by a qualified healthcare provider with expertise in foot and ankle surgery.

5. When to use CPT code 28050

CPT code 28050 should be used when a healthcare provider performs an arthrotomy with biopsy on the intertarsal or tarsometatarsal joint. It is important to ensure that the procedure is medically necessary and supported by the patient’s clinical presentation and diagnostic findings. This code should not be used for other joint biopsies or procedures performed on different joints.

6. Documentation requirements

To support a claim for CPT 28050, the healthcare provider must document the following information:

• Indication for the procedure and the specific joint being biopsied
• Details of the surgical technique used, including the size and location of the incision
• Description of any abnormalities or findings during the exploration of the joint
• Type of biopsy performed and the specific tissue obtained
• Use of any additional procedures or interventions, such as irrigation or drain placement
• Post-operative care instructions and any follow-up plans

7. Billing guidelines

When billing for CPT 28050, it is important to ensure that the procedure was performed on the intertarsal or tarsometatarsal joint. The healthcare provider should use the appropriate CPT code based on the specific joint being biopsied. It is also important to follow any specific billing guidelines provided by the payer or insurance company to ensure accurate reimbursement.

8. Historical information

CPT 28050 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 an arthrotomy with biopsy on the intertarsal joint to investigate a patient’s persistent foot pain.
2. An orthopedic surgeon conducting an arthrotomy with biopsy on the tarsometatarsal joint to diagnose a suspected inflammatory condition.
3. A foot and ankle specialist performing an arthrotomy with biopsy on the intertarsal joint to assess the extent of joint damage in a patient with arthritis.
4. A rheumatologist conducting an arthrotomy with biopsy on the tarsometatarsal joint to investigate a patient’s joint swelling and inflammation.
5. A podiatric surgeon performing an arthrotomy with biopsy on the intertarsal joint to evaluate a patient’s chronic foot instability.