How To Use CPT Code 28446

CPT 28446 describes the procedure of open osteochondral autograft on the talus, which involves transferring healthy cartilage from one part of the patient’s body to a defective area of the ankle bone. 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 28446?

CPT 28446 is used to describe the open osteochondral autograft procedure performed on the talus. This procedure involves moving healthy cartilage from one area of the patient’s body to a defective area of the ankle bone through an open incision. It is typically performed to treat a symptomatic osteochondritis dissecans lesion (OCD).

2. Official Description

The official description of CPT code 28446 is: ‘Open osteochondral autograft, talus (includes obtaining graft[s]).’ This code should not be reported in conjunction with CPT codes 27705 or 27707. For arthroscopic osteochondral talus graft, CPT code 29892 should be used. For open osteochondral allograft or repairs with industrial grafts, CPT code 28899 is appropriate.

3. Procedure

1. The provider begins by making an incision down to the area of the talus defect.
2. They then scrape and excise the damaged area until they reach the healthy part of the bone.
3. A coring reamer system is used to obtain an osteochondral graft from the patient’s articular cartilage.
4. The graft is inserted into the damaged part of the talus, potentially using pins and screws for stabilization.
5. Hemostasis is ensured at the site to stop any bleeding, and the excised area is closed in layers.

4. Qualifying circumstances

CPT 28446 is performed on patients with symptomatic osteochondritis dissecans lesions on the talus. The procedure involves transferring healthy cartilage from one part of the patient’s body to the defective area of the ankle bone. It is important to note that CPT 28446 should not be reported with CPT codes 27705 or 27707, as they are not compatible. Additionally, for arthroscopic osteochondral talus graft, CPT code 29892 should be used, and for open osteochondral allograft or repairs with industrial grafts, CPT code 28899 is appropriate.

5. When to use CPT code 28446

CPT code 28446 should be used when performing an open osteochondral autograft procedure on the talus. It is specifically used for transferring healthy cartilage from one part of the patient’s body to a defective area of the ankle bone. This code should not be used in conjunction with CPT codes 27705 or 27707. For arthroscopic osteochondral talus graft, CPT code 29892 should be used, and for open osteochondral allograft or repairs with industrial grafts, CPT code 28899 is appropriate.

6. Documentation requirements

To support a claim for CPT code 28446, the provider must document the following information:

• Patient’s diagnosis of symptomatic osteochondritis dissecans lesion on the talus
• Details of the procedure, including the use of a coring reamer system and any additional stabilization methods
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 28446, ensure that the procedure performed is an open osteochondral autograft on the talus. This code should not be reported with CPT codes 27705 or 27707. For arthroscopic osteochondral talus graft, CPT code 29892 should be used, and for open osteochondral allograft or repairs with industrial grafts, CPT code 28899 is appropriate. It is important to accurately report the procedure performed to ensure proper reimbursement.

8. Historical information

CPT code 28446 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes an open osteochondral autograft procedure on the talus to treat a symptomatic osteochondritis dissecans lesion.
2. The provider performs an open osteochondral autograft on the talus, transferring healthy cartilage to the defective area of the ankle bone.
3. An individual undergoes an open osteochondral autograft procedure on the talus to address a symptomatic osteochondritis dissecans lesion.
4. The provider performs an open osteochondral autograft on the talus, using a coring reamer system to obtain the graft from the patient’s articular cartilage.
5. A patient receives an open osteochondral autograft on the talus, with the graft inserted into the damaged part of the ankle bone.
6. The provider performs an open osteochondral autograft on the talus, ensuring hemostasis at the site and closing the excised area in layers.
7. An individual undergoes an open osteochondral autograft procedure on the talus to treat a symptomatic osteochondritis dissecans lesion.
8. The provider performs an open osteochondral autograft on the talus, transferring healthy cartilage to the defective area of the ankle bone.
9. A patient receives an open osteochondral autograft on the talus, with the graft inserted into the damaged part of the ankle bone.