How To Use CPT Code 28110

CPT 28110 describes the partial excision of the fifth metatarsal head, also known as a bunionette, as a separate procedure. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28110?

CPT 28110 is used to describe the partial excision of the fifth metatarsal head, which is the bony prominence on the outside of the foot near the toes. This procedure involves making an incision at the fifth metatarsal head and removing a small portion of the bone to address a bony lesion or bunion deformity.

2. Official Description

The official description of CPT code 28110 is: ‘Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure).’

3. Procedure

1. The surgeon makes an incision at the fifth metatarsal head, which is the bony prominence on the outside of the foot near the toes.
2. The surgeon identifies the exostosis or bunion deformity.
3. A small portion of the metatarsal head is excised.

4. Qualifying circumstances

CPT 28110 is performed on patients who have a bony lesion or bunion deformity on the fifth metatarsal head. This procedure is typically done by a surgeon and is considered a separate procedure from other foot and toe excisions. It is important to note that Medicare may have specific guidelines regarding the reporting of CPT 28110 when performed on the same toe as other procedures.

5. When to use CPT code 28110

CPT code 28110 should be used when a surgeon performs a partial excision of the fifth metatarsal head as a separate procedure. It is important to review payer guidelines to ensure proper reporting, especially when CPT 28110 is performed on the same toe as other procedures.

6. Documentation requirements

To support a claim for CPT 28110, the surgeon must document the following information:

• Identification of the bony lesion or bunion deformity on the fifth metatarsal head
• Description of the incision made at the fifth metatarsal head
• Details of the excision, including the amount of bone removed

7. Billing guidelines

When billing for CPT 28110, it is important to follow payer guidelines and review any National Correct Coding Initiative (NCCI) edits that may apply. If the surgeon performs both CPT 28110 and another procedure on the same toe, modifier 59 (Distinct procedural service) may be necessary to indicate that the excision is a separate procedure. Medicare guidelines may differ from other payers, so it is important to understand the specific requirements for proper billing.

8. Historical information

CPT 28110 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 a partial excision of the fifth metatarsal head to address a bony lesion on a patient’s foot.
2. A patient presents with a bunion deformity on the fifth metatarsal head, and the surgeon performs a partial excision as a separate procedure.
3. A bunionette on the outside of a patient’s foot requires a partial excision of the fifth metatarsal head, which is performed by a surgeon.
4. A surgeon removes a bony lesion from the fifth metatarsal head of a patient’s foot through a partial excision procedure.
5. A patient undergoes a separate procedure for the partial excision of the fifth metatarsal head to address a bunion deformity.
6. A surgeon performs a partial excision of the fifth metatarsal head to alleviate pain caused by a bony lesion on the patient’s foot.
7. A patient with a bunionette on the outside of their foot undergoes a partial excision of the fifth metatarsal head as a separate procedure.
8. A surgeon excises a small portion of the fifth metatarsal head to remove a bony lesion from the patient’s foot.
9. A patient’s bunion deformity on the fifth metatarsal head is addressed through a separate procedure involving a partial excision.
10. A surgeon performs a partial excision of the fifth metatarsal head to correct a bony lesion on the patient’s foot.