How To Use CPT Code 28436

CPT 28436 describes the percutaneous skeletal fixation of a talus fracture, with manipulation. 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 28436?

CPT 28436 can be used to describe the percutaneous skeletal fixation of a talus fracture, with manipulation. This code is used when the provider performs treatment of a talus fracture using screws and pins through the skin, along with the adjustment or manipulation of the fractured bone.

2. Official Description

The official description of CPT code 28436 is: ‘Percutaneous skeletal fixation of talus fracture, with manipulation.’

3. Procedure

1. The provider assesses the talus fracture and determines the need for percutaneous skeletal fixation.
2. The patient is appropriately prepped and anesthetized.
3. The provider adjusts the fractured fragment by exerting pushing or pulling force on the foot and leg to reduce the fracture.
4. A small incision is made in the skin over the fractured site.
5. Pins and screws are inserted through the incision to hold the reduced fracture fragment in place.
6. The wound is closed by suturing the skin.
7. The ankle is placed in a cast or brace for a period of four to six weeks.
8. An X-ray examination of the talus may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

Patients eligible to receive CPT 28436 services are those with a talus fracture that requires percutaneous skeletal fixation and manipulation. The provider must perform the procedure using screws and pins through the skin. The patient must also be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 28436

CPT code 28436 should be used when the provider performs percutaneous skeletal fixation of a talus fracture, with manipulation. This code should be used for each instance of the procedure performed on a patient. It is important to note that CPT code 28436 should not be used for open treatment of a talus fracture with or without internal fixation.

6. Documentation requirements

To support a claim for CPT 28436, the provider must document the following information:

• Diagnosis of talus fracture and the need for percutaneous skeletal fixation
• Details of the procedure performed, including the use of screws and pins through the skin
• Date of the procedure
• Start and end time of the procedure
• Confirmation of reduction of the fracture, if applicable
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 28436, ensure that the provider performs percutaneous skeletal fixation of a talus fracture, with manipulation. This code should not be reported with other codes for open treatment of a talus fracture. It is also important to separately report any X-ray examinations performed during the procedure using the appropriate codes.

8. Historical information

CPT 28436 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 provider performs percutaneous skeletal fixation of a talus fracture, with manipulation, using screws and pins through the skin.
2. A patient with a talus fracture undergoes the procedure, which includes adjustment of the fractured bone and the use of percutaneous skeletal fixation.
3. A provider performs percutaneous skeletal fixation of a talus fracture, with manipulation, and confirms the reduction of the fracture through an X-ray examination.
4. A patient undergoes the procedure, which involves the insertion of pins and screws through a small incision to hold the reduced fracture fragment in place.
5. A provider performs percutaneous skeletal fixation of a talus fracture, with manipulation, and places the ankle in a cast or brace for proper healing.
6. A patient with a talus fracture undergoes the procedure, which includes the adjustment of the fractured fragment and the closure of the wound by suturing the skin.
7. A provider performs percutaneous skeletal fixation of a talus fracture, with manipulation, and documents the details of the procedure in the patient’s medical record.
8. A patient undergoes the procedure, which involves the appropriate prepping and anesthetizing of the foot and leg before the adjustment and fixation of the talus fracture.
9. A provider performs percutaneous skeletal fixation of a talus fracture, with manipulation, and provides post-procedure care instructions to the patient.
10. A patient with a talus fracture undergoes the procedure, which includes the confirmation of the reduction of the fracture through an X-ray examination.