How To Use CPT Code 28150

CPT 28150 describes the surgical procedure known as phalangectomy, which involves the removal of one phalanx of the toe to treat disease or deformity. 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 28150?

CPT 28150 is a code used to describe the surgical removal of one phalanx of the toe. This procedure is performed to treat disease or deformity in the affected toe. If the condition cannot be treated with a partial excision, a complete removal of the bone may be necessary.

2. Official Description

The official description of CPT code 28150 is: ‘Phalangectomy, toe, each toe.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. An incision is made over the affected phalanx.
3. The provider carefully retracts the nerves and tendons to gain access to the affected area.
4. The affected phalanx is identified, exposed, and completely removed using a bone saw.
5. The surgical area is then closed in layers.

4. Qualifying circumstances

CPT 28150 is performed when there is a need to surgically remove one phalanx of the toe to treat disease or deformity. The procedure is typically reserved for cases where a partial excision is not sufficient. It is important to note that this procedure should only be performed by a qualified healthcare professional.

5. When to use CPT code 28150

CPT code 28150 should be used when a provider performs the surgical removal of one phalanx of the toe. It is important to ensure that the procedure is medically necessary and meets the criteria for this specific code.

6. Documentation requirements

To support a claim for CPT code 28150, the healthcare professional must document the following information:

• The patient’s diagnosis and the need for the phalangectomy
• The specific toe and phalanx that was removed
• The date of the procedure
• A detailed description of the surgical technique used
• Any complications or additional procedures performed
• The provider’s signature

7. Billing guidelines

When billing for CPT code 28150, it is important to ensure that the procedure meets the criteria for this specific code. It should not be reported with other codes unless there are additional procedures performed during the same session. It is also important to follow any specific guidelines provided by the payer or insurance company.

8. Historical information

CPT code 28150 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 patient undergoes phalangectomy of the second toe to treat severe osteoarthritis.
2. A provider performs phalangectomy of the fifth toe to correct a deformity caused by a congenital condition.
3. A patient with a history of trauma undergoes phalangectomy of the big toe due to a non-healing fracture.
4. A provider performs phalangectomy of the third toe to remove a benign tumor.
5. A patient with a chronic infection undergoes phalangectomy of the fourth toe to prevent further spread of the infection.
6. A provider performs phalangectomy of the second and third toes to address severe deformities caused by rheumatoid arthritis.
7. A patient with a history of recurrent infections undergoes phalangectomy of the fifth toe to improve overall foot health.
8. A provider performs phalangectomy of the big toe to address a severe case of hammertoe.
9. A patient with a history of trauma undergoes phalangectomy of the fourth toe to correct a malunion.
10. A provider performs phalangectomy of the third toe to remove a bone cyst.