How To Use CPT Code 28456

CPT 28456 describes the percutaneous skeletal fixation of a tarsal bone fracture (except talus and calcaneus) 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 28456?

CPT 28456 can be used to describe the percutaneous skeletal fixation of a tarsal bone fracture (except talus and calcaneus) with manipulation. This code is used when the provider performs treatment for a fracture in any of the seven tarsal bones located in the midfoot and rearfoot area. The treatment involves the use of screws and pins inserted through the skin to hold the fractured bone in place, along with manipulation or adjustment of the fractured bone.

2. Official Description

The official description of CPT code 28456 is: ‘Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each.’

3. Procedure

1. The provider assesses the tarsal bone fracture and determines the need for percutaneous skeletal fixation.
2. The provider performs manipulation or adjustment of the fractured bone to reduce the fracture.
3. A small incision is made in the skin over the fractured site.
4. Pins and screws are inserted through the incision to hold the reduced fracture fragment in place.
5. The ankle is placed in a cast or brace for four to six weeks to support the healing process.
6. An X-ray examination may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

Patients eligible to receive CPT 28456 services are those with a tarsal bone fracture (except talus and calcaneus) that requires percutaneous skeletal fixation with manipulation. The procedure is performed by a provider who is trained and qualified to perform this specific treatment. The patient must have a fracture in one of the seven tarsal bones located in the midfoot and rearfoot area.

5. When to use CPT code 28456

CPT code 28456 should be used when a provider performs percutaneous skeletal fixation of a tarsal bone fracture (except talus and calcaneus) with manipulation. This code is used for each tarsal bone fracture treated by the provider.

6. Documentation requirements

To support a claim for CPT 28456, the provider must document the following information:

• Diagnosis of the tarsal bone fracture
• Details of the percutaneous skeletal fixation procedure, including manipulation and the use of screws and pins
• Date of the procedure
• Incision site and size
• Type and number of screws and pins used
• Confirmation of fracture reduction through X-ray examination, if performed

7. Billing guidelines

When billing for CPT 28456, ensure that the provider performs percutaneous skeletal fixation of a tarsal bone fracture (except talus and calcaneus) with manipulation. There are no specific guidelines regarding reporting this code with other codes. However, it is important to accurately document and code all services provided during the procedure.

8. Historical information

CPT 28456 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 with manipulation for a fracture in the navicular bone of a patient’s foot.
2. A patient presents with a fractured cuboid bone, and the provider performs percutaneous skeletal fixation with manipulation to treat the fracture.
3. A provider treats a patient with a fractured medial cuneiform bone by performing percutaneous skeletal fixation with manipulation.
4. A patient sustains a fracture in the intermediate cuneiform bone, and the provider performs percutaneous skeletal fixation with manipulation to treat the fracture.
5. A provider performs percutaneous skeletal fixation with manipulation for a fracture in the lateral cuneiform bone of a patient’s foot.
6. A patient presents with a fractured tarsal bone, and the provider performs percutaneous skeletal fixation with manipulation to treat the fracture.
7. A provider treats a patient with a fractured tarsal bone by performing percutaneous skeletal fixation with manipulation.
8. A patient sustains a fracture in a tarsal bone, and the provider performs percutaneous skeletal fixation with manipulation to treat the fracture.
9. A provider performs percutaneous skeletal fixation with manipulation for a fracture in a tarsal bone of a patient’s foot.
10. A patient presents with a fractured tarsal bone, and the provider performs percutaneous skeletal fixation with manipulation to treat the fracture.