How To Use CPT Code 28280

CPT 28280 refers to syndactylization of the toes, a surgical procedure aimed at correcting congenital deformities that result in webbing or a flail toe. This procedure is particularly relevant for patients with significant gaps between existing toes, where the surgeon creates an artificial web to improve function and appearance. The operation is performed under anesthesia, and it involves careful manipulation of the toe structures to achieve the desired outcome.

1. What is CPT code 28280?

CPT code 28280 represents the surgical procedure of syndactylization of the toes, which is performed to address congenital foot deformities characterized by webbing or significant gaps between the toes. This procedure is essential for patients who may experience functional limitations or aesthetic concerns due to their toe structure. The goal of syndactylization is to create a more functional and aesthetically pleasing arrangement of the toes by fusing them together with an artificial web. This surgical intervention is particularly relevant for individuals with congenital conditions that lead to floppy or poorly aligned toes, allowing for improved mobility and comfort.

2. Qualifying Circumstances

This CPT code can be utilized in specific clinical situations where a patient presents with congenital toe deformities that necessitate surgical intervention. The procedure is appropriate for patients with significant gaps between existing toes or those with flail toes that impair function. Limitations may include cases where the toe structure is not conducive to syndactylization or where other surgical options may be more appropriate. It is crucial that the decision to use this code is based on a thorough evaluation of the patient’s condition and the potential benefits of the procedure.

3. When To Use CPT 28280

CPT code 28280 is used when a surgeon performs syndactylization to correct congenital toe deformities. It is important to note that this code should be used exclusively for this specific procedure and cannot be billed alongside codes for other unrelated surgical interventions performed on the same foot during the same session. The use of this code is contingent upon the presence of qualifying conditions, and it should be documented clearly in the patient’s medical record to justify the surgical approach taken.

4. Official Description of CPT 28280

Official Descriptor: Syndactylization, toes (eg, webbing or Kelikian type procedure)

5. Clinical Application

The clinical context for CPT code 28280 involves the surgical correction of congenital toe deformities that can lead to functional impairments and cosmetic concerns. The procedure is designed to create an artificial web between the toes, effectively reducing the gap and improving the alignment of the toe structure. This intervention is crucial for enhancing the patient’s ability to walk and engage in daily activities without discomfort or limitations caused by the deformity.

5.1 Provider Responsibilities

During the syndactylization procedure, the provider is responsible for several key actions. Initially, the surgeon conducts a thorough preoperative evaluation to assess the patient’s condition and determine the appropriateness of the procedure. Once the decision is made, the provider administers anesthesia and makes a dorsal incision along the space between the affected toes. After retracting the skin and soft tissue, the surgeon performs osteotomies at the base of each proximal phalanx to align the bones properly. The final steps involve closing the incisions, creating the artificial webbing, controlling any bleeding, and applying a sterile dressing to the surgical site. Post-surgical management is also a critical responsibility, ensuring proper healing and addressing any complications that may arise.

5.2 Unique Challenges

One of the unique challenges associated with syndactylization is the complexity of the surgical procedure itself, which requires a high level of precision and skill. The surgeon must carefully navigate the anatomy of the foot to avoid damaging surrounding structures while achieving the desired alignment of the toes. Additionally, there may be variations in the degree of webbing required based on the individual patient’s anatomy, which can complicate the surgical approach. Postoperative care is also critical, as the provider must monitor for complications such as infection or improper healing, which can impact the overall success of the procedure.

5.3 Pre-Procedure Preparations

Before performing syndactylization, the provider must conduct a comprehensive evaluation of the patient’s foot structure and overall health. This may include imaging studies to assess the alignment of the bones and the extent of the deformity. The provider should also review the patient’s medical history and any previous surgeries or conditions that may affect the procedure. Proper preoperative planning is essential to ensure that the surgical approach is tailored to the individual needs of the patient.

5.4 Post-Procedure Considerations

After the syndactylization procedure, the patient requires careful monitoring and follow-up care. The provider must assess the surgical site for signs of infection, ensure proper healing of the incisions, and evaluate the functionality of the toes. Rehabilitation may be necessary to help the patient regain strength and mobility in the affected area. The provider should also provide guidance on activity restrictions and care for the surgical site to promote optimal recovery.

6. Relevant Terminology

Syndactylization: The surgical procedure of joining together two or more digits, often performed to correct congenital deformities.

Congenital Deformity: A physical abnormality present at birth, which may affect the structure and function of the body.

Osteotomy: A surgical procedure that involves cutting and repositioning bones to correct alignment or deformities.

Dorsal Incision: An incision made on the upper surface of the foot, typically used to access underlying structures during surgery.

Proximal Phalanx: The bone in the toe that is closest to the foot, which plays a crucial role in toe movement and alignment.

7. Clinical Examples

1. A child born with a significant gap between the second and third toes undergoes syndactylization to improve toe alignment and function.

2. An adult with a congenital toe deformity experiences discomfort while walking and opts for syndactylization to alleviate the issue.

3. A patient with a flail toe resulting from a congenital condition seeks surgical intervention to enhance mobility through syndactylization.

4. A teenager with webbed toes is referred for syndactylization to improve both function and cosmetic appearance.

5. A young athlete with congenital toe deformities undergoes syndactylization to prevent further complications during sports activities.

6. A patient with a history of toe surgeries requires syndactylization to address persistent gaps between the toes.

7. A child with syndactyly is evaluated for surgical correction to improve foot function and appearance.

8. An individual with congenital toe webbing seeks syndactylization to enhance their quality of life and mobility.

9. A patient with a congenital foot deformity is counseled on the benefits of syndactylization to correct their toe alignment.

10. A healthcare provider discusses the surgical options for syndactylization with a family concerned about their child’s congenital toe condition.