How To Use CPT Code 28475

CPT code 28475 describes the closed treatment of a metatarsal 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 28475?

CPT 28475 can be used to describe the closed treatment of a metatarsal fracture with manipulation. This code is used when a provider adjusts the fractured bone by exerting pushing or pulling force on the foot to reduce the fracture. The foot is then placed in a cast or brace for four to six weeks to allow for proper healing.

2. Official Description

The official description of CPT code 28475 is: ‘Closed treatment of metatarsal fracture; with manipulation, each.’

3. Procedure

1. The provider assesses the metatarsal fracture and determines the need for closed treatment with manipulation.
2. The patient is appropriately prepped and anesthetized.
3. The provider adjusts the fractured fragment by exerting pushing or pulling force on the foot to reduce the fracture.
4. The foot is placed in a cast or brace for four to six weeks to allow for proper healing.
5. An X-ray examination may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

Patients eligible to receive CPT 28475 services are those with a metatarsal fracture that requires closed treatment with manipulation. The provider must assess the fracture and determine the need for this specific procedure. The patient must be appropriately prepped and anesthetized before the manipulation is performed. The foot is then placed in a cast or brace for four to six weeks to allow for proper healing.

5. When to use CPT code 28475

CPT code 28475 should be used when a provider performs closed treatment of a metatarsal fracture with manipulation. This code should be used for each metatarsal bone fracture that the provider treats using this procedure. If the provider performs closed treatment of a metatarsal fracture without manipulation, CPT code 28470 should be used instead.

6. Documentation requirements

To support a claim for CPT 28475, the provider must document the following information:

• Patient’s diagnosis of a metatarsal fracture
• Need for closed treatment with manipulation
• Date of the procedure
• Specific details of the manipulation performed
• Type of cast or brace applied
• Any X-ray examination performed to confirm the reduction of the fracture

7. Billing guidelines

When billing for CPT 28475, ensure that the provider performs closed treatment of a metatarsal fracture with manipulation. This code should not be reported with other codes for the same procedure. It is important to use the appropriate code based on the specific treatment provided. If the provider performs closed treatment of a metatarsal fracture without manipulation, CPT code 28470 should be used instead.

8. Historical information

CPT 28475 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 closed treatment with manipulation for a fractured metatarsal bone in the patient’s foot.
2. A patient presents with a metatarsal fracture, and the provider adjusts the fractured fragment to reduce the fracture.
3. A provider performs closed treatment with manipulation for a metatarsal fracture and applies a cast for four to six weeks.
4. A patient undergoes closed treatment with manipulation for a metatarsal fracture, and an X-ray examination confirms the reduction of the fracture.
5. A provider performs closed treatment with manipulation for a metatarsal fracture and instructs the patient to follow up after four to six weeks for cast removal.
6. A patient with a metatarsal fracture undergoes closed treatment with manipulation, and the provider provides instructions on weight-bearing restrictions during the healing process.
7. A provider performs closed treatment with manipulation for a metatarsal fracture and prescribes pain medication for the patient.
8. A patient undergoes closed treatment with manipulation for a metatarsal fracture, and the provider schedules a follow-up appointment to monitor the healing progress.
9. A provider performs closed treatment with manipulation for a metatarsal fracture and provides the patient with information on proper foot care during the healing process.
10. A patient with a metatarsal fracture undergoes closed treatment with manipulation, and the provider recommends physical therapy after the cast is removed to regain strength and mobility in the foot.