How To Use CPT Code 28280

CPT code 28280 describes a procedure called syndactylization, which involves creating an artificial webbing between two existing toes to correct a flail toe caused by a congenital deformity. 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 28280?

CPT 28280 is a code used to describe the syndactylization procedure, which involves joining together two existing toes to correct a flail toe caused by a congenital deformity. This procedure is performed by an orthopedic surgeon under local, regional, or general anesthesia. The surgeon makes an incision along the space between the foot cleft and extends it to the ends of the separated toes. The foot bones are aligned by performing osteotomies at the base of each proximal phalanx, and the incisions are closed by “webbing” the skin to eliminate the gap between the toes.

2. Official Description

The official description of CPT code 28280 is: ‘Syndactylization, toes (eg, webbing or Kelikian type procedure).’ This code is used to report the surgical procedure of creating an artificial webbing between two existing toes to correct a flail toe caused by a congenital deformity.

3. Procedure

1. The orthopedic surgeon evaluates the patient’s foot deformity and determines the need for syndactylization.
2. The patient is placed under local, regional, or general anesthesia.
3. The surgeon makes a dorsal incision along the space between the foot cleft and extends it to the ends of the separated toes.
4. The surgeon retracts the skin and soft tissue to expose the foot bones.
5. Osteotomies are performed at the base of each proximal phalanx to align the foot bones.
6. The surgeon closes the incisions by “webbing” the skin, eliminating the gap between the toes.
7. Bleeding is controlled, and the surgical field is closed and dressed with sterile dressings.

4. Qualifying circumstances

CPT 28280 is used for patients with congenital foot deformities that involve missing digit(s) with a large gap between existing toes. The procedure is performed by an orthopedic surgeon under anesthesia. The surgeon must evaluate the patient’s foot deformity and determine the need for syndactylization. The patient must have a flail toe caused by the congenital deformity, and the procedure aims to correct this condition.

5. When to use CPT code 28280

CPT code 28280 should be used when an orthopedic surgeon performs the syndactylization procedure to correct a flail toe caused by a congenital deformity. This code should not be used for other foot or toe procedures that do not involve joining existing toes together.

6. Documentation requirements

To support a claim for CPT 28280, the orthopedic surgeon must document the following information:

• Patient’s diagnosis of a congenital foot deformity with a flail toe
• Evaluation of the foot deformity and determination of the need for syndactylization
• Type of anesthesia used
• Details of the surgical procedure, including the incision, osteotomies, and closure
• Control of bleeding and closure of the surgical field
• Postoperative management plan
• Signature of the orthopedic surgeon performing the procedure

7. Billing guidelines

When billing for CPT 28280, ensure that the procedure is performed by an orthopedic surgeon and that the documentation supports the need for syndactylization to correct a flail toe caused by a congenital deformity. There are no specific guidelines regarding reporting CPT 28280 with other codes.

8. Historical information

CPT code 28280 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. An orthopedic surgeon performs syndactylization to correct a flail toe caused by a congenital deformity in a patient with missing digits and a large gap between existing toes.
2. A patient with a congenital foot deformity undergoes syndactylization to join two existing toes and correct a flail toe.
3. An orthopedic surgeon performs syndactylization to eliminate the gap between two existing toes and correct a flail toe in a patient with a congenital foot deformity.
4. Syndactylization is performed by an orthopedic surgeon to join two existing toes and correct a flail toe caused by a congenital deformity in a patient.
5. A patient with a congenital foot deformity undergoes syndactylization to create an artificial webbing between two existing toes and correct a flail toe.
6. An orthopedic surgeon performs syndactylization to eliminate the gap between two existing toes and correct a flail toe caused by a congenital deformity in a patient.
7. Syndactylization is performed by an orthopedic surgeon to join two existing toes and correct a flail toe in a patient with a congenital foot deformity.
8. A patient with missing digits and a large gap between existing toes undergoes syndactylization to create an artificial webbing and correct a flail toe caused by a congenital deformity.