How To Use CPT Code 28270

CPT 28270 describes a specific procedure performed on the foot and toes. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28270?

CPT 28270 is a code used to describe a surgical procedure that involves making an incision in the capsule of the metatarsophalangeal joints of the toes. This procedure is performed to restore range of motion and relieve pain caused by a contracture. The provider may also perform a tenorrhaphy, which involves suturing the tendon to strengthen it.

2. Official Description

The official description of CPT code 28270 is: ‘Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure).’ This code specifically refers to the surgical incision of the joint capsule in the metatarsophalangeal joints of the toes.

3. Procedure

1. When performing CPT 28270, the provider begins by preparing and anesthetizing the patient.
2. An incision is made over the metatarsophalangeal joints to expose the joint capsule.
3. The provider then incises the joint capsule to release the contracture, allowing for improved range of motion.
4. If necessary, the provider may also perform a tenorrhaphy, which involves suturing the tendon to strengthen it.
5. After completing the procedure, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision. A cast may be applied to support the foot during the healing process.

4. Qualifying circumstances

CPT 28270 is typically performed on patients who have a contracture in the metatarsophalangeal joints of the toes, causing pain and limited range of motion. The procedure is intended to restore mobility and alleviate discomfort. It is important to note that this code should only be reported when the provider performs the procedure independently, as it is designated as a separate procedure.

5. When to use CPT code 28270

CPT code 28270 should be used when the provider performs a capsulotomy on the metatarsophalangeal joints of the toes, either with or without a tenorrhaphy. This code is appropriate when the procedure is performed as a separate, independent procedure. It is important to ensure that the documentation supports the use of this specific code.

6. Documentation requirements

To support a claim for CPT code 28270, the provider must document the following information:

• The patient’s diagnosis and the need for the capsulotomy procedure
• Details of the procedure performed, including whether a tenorrhaphy was also performed
• Date of the procedure
• Any additional relevant information, such as the size of the incision or any complications encountered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 28270, it is important to ensure that the documentation supports the use of this specific code. This procedure should only be reported when performed independently and not as a component of a larger, related service. It is also important to review any specific billing guidelines provided by the payer to ensure accurate coding and reimbursement.

8. Historical information

CPT code 28270 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 a contracture in the metatarsophalangeal joint of their big toe undergoes a capsulotomy procedure to restore range of motion and alleviate pain.
2. A provider performs a capsulotomy on the metatarsophalangeal joints of multiple toes to address contractures and improve mobility.
3. A patient with a contracture in the metatarsophalangeal joint of their small toe undergoes a capsulotomy procedure, along with a tenorrhaphy, to strengthen the tendon and improve function.
4. A provider performs a capsulotomy on the metatarsophalangeal joint of a patient’s second toe, followed by a tenorrhaphy, to address a contracture and improve range of motion.
5. A patient with contractures in multiple metatarsophalangeal joints undergoes separate capsulotomy procedures to restore mobility and alleviate pain.
6. A provider performs a capsulotomy on the metatarsophalangeal joint of a patient’s third toe, followed by a tenorrhaphy, to address a contracture and improve function.
7. A patient with a contracture in the metatarsophalangeal joint of their fourth toe undergoes a capsulotomy procedure to restore range of motion and alleviate discomfort.
8. A provider performs a capsulotomy on the metatarsophalangeal joint of a patient’s fifth toe, followed by a tenorrhaphy, to address a contracture and improve mobility.
9. A patient with contractures in multiple metatarsophalangeal joints undergoes separate capsulotomy procedures to restore function and alleviate pain.
10. A provider performs a capsulotomy on the metatarsophalangeal joint of a patient’s second toe to address a contracture and improve range of motion.