How To Use CPT Code 28238

CPT 28238 describes a surgical procedure that involves the reconstruction and advancement of the posterior tibial tendon, along with the excision of an accessory tarsal navicular bone. This article will provide an overview of CPT code 28238, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 28238?

CPT 28238 is a code used to describe a surgical procedure that involves the repositioning of the posterior tibial tendon in the ankle and the excision of an accessory tarsal navicular bone. This procedure is performed to relieve pain and discomfort in patients. It is important to note that CPT code 28238 should not be used for subcutaneous tenotomy or tendon transfer procedures.

2. Official Description

The official description of CPT code 28238 is: ‘Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type procedure).’ It is important to note that this code should not be used for subcutaneous tenotomy or tendon transfer procedures.

3. Procedure

1. The provider begins by making an incision over the navicular bone and along the course of the posterior tibial tendon.
2. Subcutaneous tissue is dissected to expose and remove the accessory navicular bone.
3. The provider checks for laxity of the posterior tibial tendon and determines the need for tendon reconstruction.
4. The distal end of the posterior tibial tendon is detached and advanced by drilling a hole through the navicular bone.
5. The tendon is passed through the hole and sutured back on itself to shorten its effective length.
6. An alternate two-hole attachment or a surgical anchor may be used for tenodesis.
7. The provider performs a layered closure and applies a sterile dressing and a cast with the foot in a neutral position.

4. Qualifying circumstances

CPT code 28238 is typically used for patients who have an accessory tarsal navicular bone causing pain and discomfort. The procedure is performed by a qualified healthcare professional to relieve symptoms and improve the patient’s condition. It is important to note that this code should not be used for subcutaneous tenotomy or tendon transfer procedures.

5. When to use CPT code 28238

CPT code 28238 should be used when a surgical procedure involving the reconstruction and advancement of the posterior tibial tendon, along with the excision of an accessory tarsal navicular bone, is performed. It is important to ensure that the procedure meets the specific criteria outlined in the code description. This code should not be used for subcutaneous tenotomy or tendon transfer procedures.

6. Documentation requirements

To support a claim for CPT code 28238, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for the surgical procedure
• Details of the procedure performed, including the repositioning of the posterior tibial tendon and the excision of the accessory tarsal navicular bone
• Date of the procedure
• Any additional procedures or techniques used during the surgery
• Post-operative care instructions and follow-up plans
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 28238, it is important to ensure that the procedure meets the specific criteria outlined in the code description. This code should not be reported with subcutaneous tenotomy or tendon transfer codes. It is important to follow the appropriate coding guidelines and modifiers when submitting the claim for reimbursement.

8. Historical information

CPT code 28238 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 28238

Five similar codes to CPT code 28238 include:

• CPT 28232: This code is used to report a procedure that includes both a partial excision of the navicular bone and excision of the accessory navicular, along with the reconstruction of the posterior tibial tendon.
• CPT 28234: This code is used for the excision of the accessory navicular bone without the reconstruction of the posterior tibial tendon.
• CPT 28270: This code is used for the correction of a flatfoot deformity, which may involve the reconstruction of the posterior tibial tendon.
• CPT 28285: This code is used for the correction of a bunion deformity, which may involve the reconstruction of the posterior tibial tendon.
• CPT 28296: This code is used for the correction of a hammertoe deformity, which may involve the reconstruction of the posterior tibial tendon.

9. Examples

1. A patient with an accessory tarsal navicular bone undergoes a surgical procedure involving the reconstruction and advancement of the posterior tibial tendon, along with the excision of the accessory bone, to relieve pain and improve foot function.
2. A healthcare professional performs a surgical procedure on a patient with a painful accessory tarsal navicular bone, repositioning the posterior tibial tendon and excising the accessory bone to alleviate symptoms and improve the patient’s condition.
3. A surgical procedure is performed on a patient with an accessory tarsal navicular bone causing pain and discomfort, involving the reconstruction and advancement of the posterior tibial tendon, along with the excision of the accessory bone, to restore foot function and alleviate symptoms.
4. A qualified healthcare professional performs a surgical procedure on a patient with an accessory tarsal navicular bone, repositioning the posterior tibial tendon and excising the accessory bone to relieve pain and improve the patient’s condition.
5. A patient undergoes a surgical procedure involving the reconstruction and advancement of the posterior tibial tendon, along with the excision of an accessory tarsal navicular bone, to alleviate pain and improve foot function.
6. A healthcare professional performs a surgical procedure on a patient with a painful accessory tarsal navicular bone, repositioning the posterior tibial tendon and excising the accessory bone to alleviate symptoms and improve the patient’s condition.