How To Use CPT Code 28304

CPT 28304 describes a surgical procedure involving the osteotomy of tarsal bones, excluding the calcaneus or talus. 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 28304?

CPT 28304 involves the surgical incision or transection of tarsal bones, excluding the calcaneus or talus. This procedure is performed to treat chronic ankle instability, tarsal coalition, dislocation, or fracture.

2. Official Description

The official description of CPT code 28304 is: ‘Osteotomy, tarsal bones, other than calcaneus or talus.’

3. Procedure

1. The provider makes an incision over the involved tarsal bone or bones, such as the cuneiform, navicular, or cuboid bones.
2. Associated nerves and tendons are retracted, and abnormal bony, cartilaginous, or fibrous connections between the tarsal bones are incised.
3. The provider then realigns the bones.
4. Any bleeding is controlled, instruments are removed, and the incision in the skin is closed in layers.
5. A sterile dressing and a cast or splint are applied.

4. Qualifying circumstances

CPT 28304 is performed on patients with chronic ankle instability, tarsal coalition, dislocation, or fracture. It is important to note that the procedure excludes the calcaneus or talus.

5. When to use CPT code 28304

CPT code 28304 should be used when a surgical osteotomy of tarsal bones, excluding the calcaneus or talus, is performed. It is not appropriate to use this code for procedures involving the calcaneus or talus.

6. Documentation requirements

To support a claim for CPT 28304, the provider must document the following information:

• Patient’s diagnosis indicating chronic ankle instability, tarsal coalition, dislocation, or fracture
• Details of the surgical procedure, including the specific tarsal bones involved
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 28304, ensure that the procedure involves the osteotomy of tarsal bones, excluding the calcaneus or talus. It is important to follow the specific documentation requirements and guidelines provided by the payer. Report any additional procedures or complications separately, if applicable.

8. Historical information

CPT 28304 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a code change on January 1, 2010, with the description remaining the same.

9. Examples

1. A patient undergoes an osteotomy of the tarsal bones to treat chronic ankle instability.
2. A provider performs an osteotomy of the tarsal bones to address tarsal coalition.
3. A surgical procedure involving the osteotomy of the tarsal bones is performed to treat a dislocation.
4. A patient with a fracture undergoes an osteotomy of the tarsal bones for proper realignment.
5. A provider performs an osteotomy of the tarsal bones to address multiple conditions, including chronic ankle instability, tarsal coalition, dislocation, and fracture.
6. An osteotomy of the tarsal bones is performed as part of a comprehensive foot reconstruction surgery.
7. A patient undergoes an osteotomy of the tarsal bones to correct a previous unsuccessful surgery.
8. A provider performs an osteotomy of the tarsal bones to address a congenital foot deformity.
9. An osteotomy of the tarsal bones is performed to improve foot function and alleviate pain in a patient with a foot deformity.
10. A surgical procedure involving the osteotomy of the tarsal bones is performed to correct a malalignment caused by trauma.