How To Use CPT Code 28309

CPT 28309 describes a surgical procedure performed on multiple metatarsal bones to correct a foot deformity known as pes cavus. This article will provide an overview of CPT code 28309, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 28309?

CPT 28309 is a code used to describe a surgical procedure that involves the osteotomy of multiple metatarsal bones in the foot. This procedure is performed to correct a foot deformity called pes cavus, which is characterized by an abnormally high arch. The purpose of the surgery is to realign the metatarsal bones and restore them to their proper position.

2. Official Description

The official description of CPT code 28309 is: ‘Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (e.g., Swanson type cavus foot procedure).’ This code specifically refers to the surgical correction of multiple metatarsal bones in the foot to treat pes cavus.

3. Procedure

1. The surgical procedure begins with the patient being appropriately prepped and anesthetized.
2. An incision is made over the metatarsal bones of the foot, excluding the first metatarsal.
3. The incision is deepened through the skin and soft tissue, taking care to identify and retract all vital neurovascular structures.
4. The lateral tendons, which connect muscle to bone, are moved medially.
5. The surgeon addresses any deformities observed in the multiple metatarsal bones.
6. If lengthening of the bone is required, the surgeon may transect it and pull the two pieces apart slightly, allowing for osseous regrowth to fill in the gap.
7. If shortening of the metatarsal bone is necessary, a portion of the bone is removed, and the two ends are rejoined using a screw or wire.
8. To correct an angular deformity, the surgeon realigns the metatarsal bone and secures it in place with metal screws to ensure proper healing.
9. The surgeon checks for and controls any bleeding, removes any instruments, and closes the incision in layers.

4. Qualifying circumstances

CPT 28309 is performed on patients with pes cavus, a foot deformity characterized by an abnormally high arch. The surgery is indicated when there are multiple metatarsal bones that require correction. It is important to note that this procedure is typically performed by a qualified surgeon who specializes in foot and ankle surgery.

5. When to use CPT code 28309

CPT code 28309 should be used when a surgical correction of multiple metatarsal bones is performed to treat pes cavus. It is important to ensure that the patient meets the criteria for this procedure and that the surgery is necessary to correct the foot deformity. This code should not be used for other foot or toe procedures that do not involve the osteotomy of multiple metatarsal bones.

6. Documentation requirements

Documentation for CPT code 28309 should include the following:

• Patient’s diagnosis of pes cavus
• Description of the surgical procedure performed, including the osteotomy of multiple metatarsal bones
• Date of the surgery
• Details of any additional procedures performed during the surgery
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT code 28309, it is important to ensure that the procedure was performed on multiple metatarsal bones to correct pes cavus. This code should not be reported with other foot or toe procedures that do not involve the osteotomy of multiple metatarsal bones. It is also important to follow any specific billing guidelines provided by insurance carriers or Medicare. If a surgical assistant was involved in the procedure, appropriate modifiers should be used to indicate their involvement.

8. Historical information

CPT code 28309 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 patient with pes cavus undergoes surgery to correct the deformity in multiple metatarsal bones.
2. A surgeon performs an osteotomy on multiple metatarsal bones to treat pes cavus in a patient with foot pain and difficulty walking.
3. A patient with a severe high arch in their foot undergoes surgery to realign the metatarsal bones and correct the pes cavus deformity.
4. A surgeon performs a corrective procedure on multiple metatarsal bones to improve the stability and function of a patient’s foot affected by pes cavus.
5. A patient with pes cavus undergoes surgery to correct the abnormally high arch by realigning the metatarsal bones.
6. A surgeon performs an osteotomy on multiple metatarsal bones to correct the pes cavus deformity and improve the patient’s foot function.
7. A patient with pes cavus undergoes surgery to correct the foot deformity and alleviate pain and discomfort.
8. A surgeon performs a procedure on multiple metatarsal bones to correct the pes cavus deformity and improve the patient’s ability to walk and engage in daily activities.
9. A patient with pes cavus undergoes surgery to realign the metatarsal bones and correct the foot deformity that is causing pain and instability.