How To Use CPT Code 28288

CPT 28288 describes the partial removal of a metatarsal head or any associated bony growth in the foot. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28288?

CPT 28288 is used to describe a surgical procedure in which a portion of a single metatarsal head in the foot is removed. This can involve the removal of the metatarsal head itself, known as condylectomy, or any abnormal bony growth associated with it, known as exostectomy.

2. Official Description

The official description of CPT code 28288 is the “Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head.” This code specifically refers to the surgical removal of a portion of a metatarsal head in the foot.

3. Procedure

1. To perform CPT 28288, the healthcare provider begins by preparing and anesthetizing the patient.
2. An incision is made over the metatarsophalangeal joint, where the metatarsal bone of the foot connects to the phalanx bone of the toe.
3. The provider then retracts the tendons and creates an incision to access the metatarsal head.
4. A portion of the metatarsal head, including the condyle or any associated exostosis, is excised.
5. The provider ensures a smooth surface at the metatarsal head, controls bleeding, and closes the surgical field with sutures.
6. A sterile dressing is applied to the surgical site to promote healing.

4. Qualifying circumstances

CPT 28288 is performed on patients who require the removal of a portion of a metatarsal head or any associated bony growth. This procedure is typically indicated for conditions such as abnormal bony growths or deformities in the foot. The patient must meet the criteria for the procedure, and the healthcare provider must determine the medical necessity for performing CPT 28288.

5. When to use CPT code 28288

CPT code 28288 should be used when a healthcare provider performs a partial removal of a metatarsal head or any associated bony growth in the foot. This code is appropriate for reporting the procedure on each metatarsal head that requires the ostectomy. It is important to follow payer instructions and utilize appropriate modifiers, such as 59 or modifiers TA to T9, to indicate multiple units or specify the location of the procedure if necessary.

6. Documentation requirements

To support a claim for CPT 28288, the healthcare provider must document the following information:

• Patient’s diagnosis and the medical necessity for the procedure
• Details of the surgical procedure performed, including the specific metatarsal head involved
• Date of the procedure
• Incision site and approach
• Extent of the excision and any associated bony growth removed
• Any additional procedures performed during the same surgical session
• Postoperative care instructions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 28288, ensure that the procedure is performed by a qualified healthcare provider and that the documentation supports the medical necessity for the ostectomy. Follow payer guidelines for reporting multiple units or specifying the location of the procedure using appropriate modifiers. It is important to review the specific billing requirements of each payer to ensure accurate and timely reimbursement.

8. Historical information

CPT 28288 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 podiatrist performs a partial removal of the metatarsal head in the left foot of a patient with a bony growth.
2. An orthopedic surgeon excises a portion of the metatarsal head in the right foot of a patient with a deformity.
3. A foot and ankle specialist performs a condylectomy on the second metatarsal head of a patient with chronic pain.
4. A podiatric surgeon removes an exostosis from the fifth metatarsal head of a patient with a foot deformity.
5. An orthopedic physician performs a partial removal of the metatarsal head in the left foot of a patient with a traumatic injury.
6. A foot and ankle surgeon excises a portion of the metatarsal head in the right foot of a patient with a recurrent bony growth.
7. A podiatrist performs a condylectomy on the third metatarsal head of a patient with a congenital abnormality.
8. An orthopedic surgeon removes an exostosis from the fourth metatarsal head of a patient with a chronic inflammatory condition.
9. A foot and ankle specialist performs a partial removal of the metatarsal head in the left foot of a patient with a degenerative joint disease.
10. A podiatric surgeon excises a portion of the metatarsal head in the right foot of a patient with a traumatic injury.