How To Use CPT Code 28240

CPT 28240 describes a procedure that involves the tenotomy, lengthening, or release of the abductor hallucis muscle. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28240?

CPT 28240 is a code that represents a surgical procedure involving the abductor hallucis muscle. This procedure may include the lengthening or release of the tendon that connects the abductor hallucis muscle to a bone in the big toe. The purpose of this procedure is to relieve foot pain by adjusting the tension on the muscle or lengthening the tendon.

2. Official Description

The official description of CPT code 28240 is: ‘Tenotomy, lengthening, or release, abductor hallucis muscle.’

3. Procedure

1. The provider begins by making an incision over the first metatarsal of the great toe.
2. They then divide and retract the fascia to expose the abductor hallucis muscle.
3. The distal insertion of the muscle at the bone of the great toe is freed, allowing the toe to move into alignment.
4. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 28240 is performed when a patient experiences foot pain that can be relieved by adjusting the tension on the abductor hallucis muscle. The procedure is typically done on patients who have tried conservative treatments without success. It is important to note that this procedure should only be performed by a qualified healthcare professional.

5. When to use CPT code 28240

CPT code 28240 should be used when a provider performs a tenotomy, lengthening, or release of the abductor hallucis muscle. This code is appropriate when the procedure is done to relieve foot pain and improve the alignment of the big toe. It is important to ensure that the documentation supports the medical necessity of the procedure.

6. Documentation requirements

To support a claim for CPT code 28240, the provider must document the following information:

• Patient’s diagnosis and symptoms indicating the need for the procedure
• Details of the procedure performed, including the specific technique used
• Date of the procedure
• Any complications or unexpected findings
• Post-procedure instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 28240, it is important to ensure that the documentation supports the medical necessity of the procedure. The procedure should only be reported once per foot. It is also important to follow any specific guidelines provided by the payer regarding the use of modifiers or additional documentation requirements.

8. Historical information

CPT code 28240 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 with chronic foot pain undergoes a tenotomy of the abductor hallucis muscle to relieve their symptoms.
2. A provider performs a lengthening procedure on the abductor hallucis muscle of a patient with a misaligned big toe.
3. A patient with a history of foot pain undergoes a release procedure on the abductor hallucis muscle to improve their mobility.
4. A provider performs a tenotomy on the abductor hallucis muscle of a patient with a foot deformity.
5. A patient with persistent foot pain undergoes a lengthening procedure on the abductor hallucis muscle to alleviate their symptoms.