How To Use CPT Code 28298

CPT 28298 describes a specific procedure used to correct a bunion on the side of the foot. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28298?

CPT 28298 is a code that represents a surgical procedure performed to correct a bunion on the side of the foot. This procedure involves the removal of bone at the base of the proximal phalanx, or big toe, to aid in straightening the toe and treating the abnormal angle caused by the bunion.

2. Official Description

The official description of CPT code 28298 is: ‘Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal phalanx osteotomy, any method.’

3. Procedure

1. The surgeon begins by making an incision over the metatarsophalangeal joint, where the metatarsal bone of the foot joins the phalanx bone of the toe.
2. Small vessels along the path are clamped and coagulated to minimize bleeding.
3. The surgeon may remove the enlarged bump of bone on the side of the foot.
4. Next, the surgeon accesses the target site of the toe bone near the metatarsal and removes bone, typically in a wedge shape, from the toe bone.
5. The bones are then aligned to be in the target position.
6. Fixation devices may be used to hold the bones in the desired position.
7. During the procedure, the surgeon may also perform a sesamoidectomy, which involves the removal of a sesamoid bone located under the big toe joint.
8. Finally, the surgeon checks for bleeding and closes the incision.

4. Qualifying circumstances

CPT 28298 is performed on patients with hallux valgus, a condition characterized by the bending of the big toe towards the second toe. The procedure is intended to reduce symptoms, restore function, and correct the deformity caused by the bunion. It is important to note that this procedure should only be performed by a qualified healthcare professional.

5. When to use CPT code 28298

CPT code 28298 should be used when a surgeon performs a correction procedure for a bunion on the side of the foot, specifically involving a proximal phalanx osteotomy. This code should be used when the procedure is performed using any method.

6. Documentation requirements

To support a claim for CPT 28298, the surgeon must document the following information:

• Patient’s diagnosis of hallux valgus
• Details of the procedure performed, including the specific method used for the proximal phalanx osteotomy
• Incision site and size
• Any additional procedures performed, such as sesamoidectomy
• Any fixation devices used
• Confirmation of proper alignment of the bones
• Confirmation of absence of bleeding
• Details of the closure of the incision

7. Billing guidelines

When billing for CPT 28298, ensure that the procedure is performed by a qualified healthcare professional. It is important to follow the specific guidelines provided by the payer and to accurately document the procedure and any additional services performed. It is also important to review all codes in the range 28289 to 28299 before finalizing the billing for bunion correction procedures.

8. Historical information

CPT 28298 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2017, with the description being updated to include the term ‘hallux valgus’.

9. Examples

1. A surgeon performs a proximal phalanx osteotomy procedure to correct a bunion on the side of the foot for a patient with hallux valgus.
2. Using a specific method, a qualified healthcare professional performs a bunion correction procedure involving a proximal phalanx osteotomy.
3. A patient with hallux valgus undergoes a surgical procedure to correct the deformity caused by the bunion, which includes a proximal phalanx osteotomy.
4. A surgeon performs a bunionectomy with sesamoidectomy and a proximal phalanx osteotomy to treat a patient’s hallux valgus.
5. Using any method available, a qualified healthcare professional performs a correction procedure for a bunion on the side of the foot, involving a proximal phalanx osteotomy.
6. A patient with hallux valgus undergoes a surgical procedure to correct the deformity caused by the bunion, which includes a proximal phalanx osteotomy.
7. A surgeon performs a bunionectomy with sesamoidectomy and a proximal phalanx osteotomy to treat a patient’s hallux valgus.
8. Using any method available, a qualified healthcare professional performs a correction procedure for a bunion on the side of the foot, involving a proximal phalanx osteotomy.
9. A patient with hallux valgus undergoes a surgical procedure to correct the deformity caused by the bunion, which includes a proximal phalanx osteotomy.
10. A surgeon performs a bunionectomy with sesamoidectomy and a proximal phalanx osteotomy to treat a patient’s hallux valgus.