How To Use CPT Code 28322

CPT 28322 describes the surgical repair of nonunion or malunion of metatarsal bones in the foot, which involves the placement of a bone graft. 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 28322?

CPT 28322 is used to describe the surgical repair of metatarsal bones in the foot that have either healed incorrectly (malunion) or have not healed at all (nonunion). This procedure involves the placement of a bone graft to restore function and alleviate pain. It is performed by a healthcare provider when the fractured site has a poor blood supply or becomes infected.

2. Official Description

The official description of CPT code 28322 is: ‘Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft).’ This code includes the surgical repair of metatarsal bones that have not rejoined or have healed in the wrong position, as well as the placement of a bone graft if necessary.

3. Procedure

1. The healthcare provider begins by making an incision over the metatarsal bones and exposing the old fracture.
2. Scar tissue between the fractured fragments is removed.
3. The provider realigns the bones and fixes them in place, removing any devitalized bone from the fracture surfaces if necessary.
4. If a bone graft is needed to fill the gap between the bone fragments, the provider can harvest bone from various sites, such as the iliac crest.
5. The graft is placed in the space between the bone fragments.
6. The fractured metatarsal bones are stabilized using metal plates, rods, or pins.
7. After the surgical correction, the provider controls bleeding, closes the incision, and applies a sterile dressing and stabilizing devices.

4. Qualifying circumstances

CPT 28322 is performed on patients with nonunion or malunion of metatarsal bones in the foot. These complications occur when the fractured site has a poor blood supply or becomes infected. The procedure is done to restore function and relieve pain. It is important to note that the code includes the placement of a bone graft if necessary.

5. When to use CPT code 28322

CPT code 28322 should be used when a healthcare provider performs surgical repair of nonunion or malunion of metatarsal bones in the foot, with or without the placement of a bone graft. This code is appropriate when the fractured site has a poor blood supply or becomes infected, and the procedure aims to restore function and alleviate pain.

6. Documentation requirements

To support a claim for CPT code 28322, the healthcare provider must document the following information:

• Patient’s diagnosis of nonunion or malunion of metatarsal bones
• Details of the surgical repair procedure performed
• Whether a bone graft was used and its source
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider

7. Billing guidelines

When billing for CPT code 28322, ensure that the procedure involves the surgical repair of nonunion or malunion of metatarsal bones in the foot, with or without the placement of a bone graft. It is important to note that the code includes the obtaining of the bone graft, so it should not be reported separately. There are no specific guidelines regarding reporting this code with other codes.

8. Historical information

CPT code 28322 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 of nonunion of a metatarsal bone in the foot, using a bone graft obtained from the iliac crest.
2. A patient presents with malunion of a metatarsal bone in the foot, and the healthcare provider performs surgical repair without the need for a bone graft.
3. A healthcare provider performs surgical repair of nonunion of multiple metatarsal bones in the foot, using a bone graft obtained from another site.
4. A patient with malunion of a metatarsal bone in the foot undergoes surgical repair, which includes the placement of a bone graft obtained from the iliac crest.
5. A healthcare provider performs surgical repair of nonunion of a metatarsal bone in the foot, without the need for a bone graft.
6. A patient presents with malunion of multiple metatarsal bones in the foot, and the healthcare provider performs surgical repair using a bone graft obtained from another site.
7. A healthcare provider performs surgical repair of nonunion of a metatarsal bone in the foot, using a bone graft obtained from the patient’s own body.
8. A patient with malunion of a metatarsal bone in the foot undergoes surgical repair, which does not require the placement of a bone graft.
9. A healthcare provider performs surgical repair of nonunion of multiple metatarsal bones in the foot, using a bone graft obtained from another patient.
10. A patient presents with malunion of a metatarsal bone in the foot, and the healthcare provider performs surgical repair using a bone graft obtained from the patient’s family member.