How To Use CPT Code 28320

CPT code 28320 describes the surgical repair of tarsal bones that have either healed incorrectly or have not rejoined. 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 28320?

CPT 28320 can be used to describe the surgical repair of tarsal bones that have either healed in the wrong position (malunion) or have not rejoined (nonunion). This procedure is performed by a healthcare provider to restore function and relieve pain in the affected area.

2. Official Description

The official description of CPT code 28320 is: ‘Repair, nonunion or malunion; tarsal bones.’

3. Procedure

1. The healthcare provider begins by making an incision over the tarsal bones and exposing the old fracture.
2. Scar tissue between the fractured fragments is removed.
3. The provider then realigns the bones and fixes them in place, removing any devitalized bone if necessary.
4. Stabilization of the fractured metatarsal bones is typically done using metal plates, rods, or pins.
5. After surgically correcting the malunion or nonunion, the provider controls bleeding, closes the incision, and applies a sterile dressing and splints, casts, or straps.

4. Qualifying circumstances

CPT 28320 is used when a patient has tarsal bones that have healed incorrectly or have not rejoined. This can occur due to poor blood supply or infection at the fractured site. The procedure is performed by a healthcare provider to restore function and relieve pain in the affected area.

5. When to use CPT code 28320

CPT code 28320 should be used when a healthcare provider performs surgical repair on tarsal bones that have healed incorrectly or have not rejoined. It is important to accurately document the specific circumstances that warrant the use of this code.

6. Documentation requirements

To support a claim for CPT 28320, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for surgical repair
• Details of the procedure performed, including the specific tarsal bones involved
• Any additional procedures or techniques used during the surgery
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 28320, ensure that the procedure meets the criteria for nonunion or malunion repair of tarsal bones. It is important to accurately document the specific circumstances that warrant the use of this code. Additionally, be aware of any bundling or unbundling guidelines that may apply to this procedure.

8. Historical information

CPT 28320 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs surgical repair on a patient with a nonunion of the tarsal bones in their foot.
2. A patient presents with a malunion of the tarsal bones in their ankle, and a healthcare provider performs surgical correction to restore proper alignment.
3. A healthcare provider performs surgical repair on a patient with a nonunion of the tarsal bones in their foot due to poor blood supply.
4. A patient undergoes surgical correction for a malunion of the tarsal bones in their foot, which has caused significant pain and limited mobility.
5. A healthcare provider performs surgical repair on a patient with a nonunion of the tarsal bones in their foot following an infection at the fractured site.
6. A patient with a malunion of the tarsal bones in their ankle undergoes surgical correction to improve function and alleviate pain.
7. A healthcare provider performs surgical repair on a patient with a nonunion of the tarsal bones in their foot, which has resulted in instability and difficulty walking.
8. A patient presents with a malunion of the tarsal bones in their foot, and a healthcare provider performs surgical correction to restore proper alignment and improve function.
9. A healthcare provider performs surgical repair on a patient with a nonunion of the tarsal bones in their foot, which has caused chronic pain and limited range of motion.
10. A patient undergoes surgical correction for a malunion of the tarsal bones in their ankle, which has resulted in deformity and difficulty wearing shoes.