How To Use CPT Code 28555

CPT 28555 describes the open treatment of tarsal bone dislocation, including internal fixation if performed. 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 28555?

CPT 28555 can be used to describe the open treatment of tarsal bone dislocation, which involves the abnormal separation of a joint in the midfoot and rearfoot area. The procedure may or may not include the use of internal fixation implants, such as pins or screws, to fix the dislocation. It is important to note that this code specifically excludes talotarsal joint dislocation, which is a joint of the talus with another tarsal bone.

2. Official Description

The official description of CPT code 28555 is: ‘Open treatment of tarsal bone dislocation, includes internal fixation, when performed.’

3. Procedure

1. The provider begins by making an incision in the skin over the dislocated joint.
2. They then carefully dissect through the subcutaneous tissue, taking care to protect the nerves and vessels.
3. The muscles are retracted to expose the dislocated bones.
4. The provider then adjusts the bones to reduce the dislocation.
5. If necessary, they may use implants like screws, nails, or wires to provide additional stability to the reduced joint.
6. The wound is closed by suturing the skin layers together.
7. A splint or brace is applied to the foot for a period of four weeks to support the healing process.
8. An X-ray examination may be performed separately to confirm the reduction of the dislocation.

4. Qualifying circumstances

CPT 28555 is used when the provider performs open treatment of a tarsal bone dislocation, other than talotarsal joint dislocation. This procedure is typically performed on patients who have experienced abnormal separation of a joint in the midfoot and rearfoot area. The use of internal fixation implants, such as pins or screws, may be necessary to stabilize the dislocated bones.

5. When to use CPT code 28555

CPT code 28555 should be used when the provider performs open treatment of a tarsal bone dislocation, including internal fixation if performed. It is important to note that this code specifically excludes talotarsal joint dislocation. If the provider performs percutaneous skeletal fixation of the tarsal bone dislocation, other than talotarsal, with manipulation, CPT code 28546 should be used. For closed treatment of the tarsal bone dislocation, other than talotarsal, CPT codes 28540-28545 should be used. If the provider performs open treatment of the talotarsal joint dislocation with or without internal fixation, CPT code 28585 should be used.

6. Documentation requirements

To support a claim for CPT 28555, the provider must document the following information:

• Diagnosis of tarsal bone dislocation
• Details of the open treatment procedure performed
• Use of internal fixation implants, if applicable
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed, such as X-ray examination
• Signature of the provider

7. Billing guidelines

When billing for CPT 28555, ensure that the provider performs open treatment of a tarsal bone dislocation, including internal fixation if performed. It is important to note that this code specifically excludes talotarsal joint dislocation. There are no specific guidelines regarding reporting CPT code 28555 with other codes. However, it is important to accurately report the procedure performed and any additional services provided. It is recommended to review the documentation guidelines and any payer-specific requirements to ensure accurate billing.

8. Historical information

CPT 28555 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2008, the code description was changed to include the option of internal or external fixation for open treatment of tarsal bone dislocation.

9. Examples

1. A provider performs open treatment of a tarsal bone dislocation in a patient who sustained a midfoot injury during a sports activity.
2. A patient presents with a rearfoot dislocation, and the provider performs open treatment to reduce and stabilize the dislocated bones.
3. A provider performs open treatment of a tarsal bone dislocation in a patient who was involved in a motor vehicle accident.
4. A patient with a history of chronic ankle instability undergoes open treatment of a tarsal bone dislocation to improve joint stability.
5. A provider performs open treatment of a tarsal bone dislocation in a patient with a congenital foot deformity.
6. A patient presents with a dislocated midfoot joint, and the provider performs open treatment to realign and stabilize the joint.
7. A provider performs open treatment of a tarsal bone dislocation in a patient who sustained a fall from a height.
8. A patient with a history of rheumatoid arthritis undergoes open treatment of a tarsal bone dislocation to alleviate joint pain and improve function.
9. A provider performs open treatment of a tarsal bone dislocation in a patient who sustained a workplace injury.
10. A patient presents with a dislocated rearfoot joint, and the provider performs open treatment to restore joint alignment and stability.