How To Use CPT Code 28120

CPT 28120 describes the partial excision of the talus or calcaneus bone using techniques such as craterization, saucerization, sequestrectomy, or diaphysectomy. This article will provide an overview of CPT code 28120, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 28120?

CPT 28120 is used to describe a surgical procedure in which the provider removes a portion of the talus or calcaneus bone. This procedure is performed to address conditions such as osteomyelitis or bossing. The excision can be done using techniques like craterization, saucerization, sequestrectomy, or diaphysectomy.

2. Official Description

The official description of CPT code 28120 is the partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) of the talus or calcaneus bone. This code specifically applies to cases involving osteomyelitis or bossing.

3. Procedure

1. During the procedure, the provider makes an incision on the posterior aspect of the foot after the patient is appropriately prepped and anesthetized.
2. The provider then dissects the soft tissues, bursa, and tendons from the insertion point of the Achilles tendon.
3. Next, the provider separates the Achilles tendon from its attachments and identifies the infected or affected portion of the talus or calcaneus bone.
4. The provider performs a partial excision of the bone using techniques like craterization, saucerization, or diaphysectomy.
5. In some cases, the provider may fill the cavity left in the bone with a bone graft or use sutures to reattach the Achilles tendon to the remaining calcaneus.
6. Finally, the provider closes the wound in layers to complete the procedure.

4. Qualifying circumstances

CPT code 28120 is used when the patient has a condition that requires the partial excision of the talus or calcaneus bone. This may include cases of osteomyelitis or bossing. The procedure is typically performed by a qualified healthcare professional who has the necessary expertise in performing bone excisions.

5. When to use CPT code 28120

CPT code 28120 should be used when a partial excision of the talus or calcaneus bone is performed using techniques like craterization, saucerization, sequestrectomy, or diaphysectomy. This code is specifically applicable to cases involving osteomyelitis or bossing. It is important to accurately document the procedure and ensure that it meets the criteria outlined in the code description.

6. Documentation requirements

Documentation for CPT code 28120 should include the following information:

• Patient’s diagnosis, indicating the need for the partial excision of the talus or calcaneus bone
• Details of the specific technique used, such as craterization, saucerization, sequestrectomy, or diaphysectomy
• Date of the procedure
• Any additional procedures performed, such as bone grafting or tendon reattachment
• Any complications or unexpected findings during the procedure
• Signature of the performing healthcare professional

7. Billing guidelines

When billing for CPT code 28120, it is important to ensure that the procedure meets the criteria outlined in the code description. The provider should accurately document the procedure and any additional services provided. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines. CPT code 28120 should not be reported with other codes unless there are separate and distinct procedures performed.

8. Historical information

CPT code 28120 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. Similar codes to CPT code 28120

Five similar codes to CPT code 28120 include:

• CPT 28122: Partial excision of the tarsal or metatarsal bone, except talus or calcaneus, using techniques like craterization, saucerization, sequestrectomy, or diaphysectomy.
• CPT 28124: Partial excision of the phalanx of the toe using techniques like craterization, saucerization, sequestrectomy, or diaphysectomy.
• CPT 28122 and CPT 28124 are similar to CPT 28120 as they involve partial excisions of bones using similar techniques, but they are specific to different anatomical locations.

9. Examples

1. A patient with osteomyelitis of the talus undergoes a partial excision of the bone using craterization.
2. A patient with bossing of the calcaneus requires a saucerization procedure to address the condition.
3. A provider performs a diaphysectomy of the talus in a patient with a bone tumor.
4. A patient with chronic osteomyelitis of the calcaneus undergoes a sequestrectomy procedure.
5. A partial excision of the talus is performed using craterization in a patient with a traumatic injury.
6. A patient with a bone infection in the calcaneus undergoes a saucerization procedure to remove the infected portion.
7. A provider performs a diaphysectomy of the talus to address a congenital bone deformity in a pediatric patient.
8. A patient with osteomyelitis of the calcaneus requires a sequestrectomy procedure to remove the necrotic bone.
9. A partial excision of the talus using craterization is performed in a patient with a bone cyst.
10. A patient with bossing of the calcaneus undergoes a saucerization procedure to alleviate pain and improve function.