How To Use CPT Code 28054

CPT 28054 describes the procedure of arthrotomy with biopsy on the interphalangeal joint of a toe or finger. 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 28054?

CPT 28054 is used to describe the surgical procedure of arthrotomy with biopsy on the interphalangeal joint. This code is specifically used when a provider cuts into a toe or finger joint to remove a biopsy sample for further examination.

2. Official Description

The official description of CPT code 28054 is: ‘Arthrotomy with biopsy; interphalangeal joint.’

3. Procedure

1. After the patient is prepped, draped, and anesthetized, the provider makes an incision over the interphalangeal joint.
2. The provider then proceeds to make an incision in the joint capsule and carefully examines it.
3. A small piece of diseased tissue is removed from the joint to be sent to pathology for further examination.
4. The area is washed with normal saline to ensure cleanliness.
5. The provider then closes the joint capsule and the wound.

4. Qualifying circumstances

CPT 28054 is performed on patients who require a biopsy of the interphalangeal joint. This procedure is typically done when there is a suspected disease or condition affecting the joint that requires further examination. The provider must make an incision into the joint capsule and remove a small piece of diseased tissue for pathology analysis.

5. When to use CPT code 28054

CPT code 28054 should be used when a provider performs an arthrotomy with biopsy on the interphalangeal joint. It is important to note that this code is specific to the interphalangeal joint and should not be used for other joints or procedures.

6. Documentation requirements

To support a claim for CPT 28054, the provider must document the following information:

• Patient’s diagnosis and the need for the arthrotomy with biopsy
• Specific details of the procedure, including the incision site and size
• Description of the joint capsule examination
• Documentation of the tissue sample removed and sent for pathology analysis
• Use of normal saline for wound cleansing
• Details of the closure of the joint capsule and wound
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 28054, ensure that the procedure performed is an arthrotomy with biopsy on the interphalangeal joint. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, be aware of any bundling or unbundling rules that may apply to this code.

8. Historical information

CPT 28054 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 surgeon performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s finger to investigate a suspected joint disease.
2. A podiatrist performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s toe to examine a possible joint infection.
3. An orthopedic surgeon performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s finger to assess a suspected joint tumor.
4. A hand surgeon performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s finger to investigate chronic joint pain.
5. A rheumatologist performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s toe to evaluate a suspected autoimmune joint disorder.
6. An orthopedic surgeon performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s finger to examine a possible joint deformity.
7. A hand surgeon performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s finger to investigate a suspected joint infection.
8. A podiatrist performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s toe to assess a suspected joint tumor.
9. An orthopedic surgeon performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s finger to investigate chronic joint pain.
10. A rheumatologist performs an arthrotomy with biopsy on the interphalangeal joint of a patient’s toe to evaluate a suspected autoimmune joint disorder.