How To Use CPT Code 28585

CPT 28585 describes the open treatment of a talotarsal joint 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 28585?

CPT 28585 can be used to describe the open treatment of a talotarsal joint dislocation, which involves the abnormal separation of a joint. The procedure may or may not include the use of internal fixation implants, such as pins or screws, to fix the dislocation. The talotarsal joint is a joint between the talus bone and another tarsal bone in the midfoot and rearfoot area.

2. Official Description

The official description of CPT code 28585 is: ‘Open treatment of talotarsal joint dislocation, includes internal fixation, when performed.’

3. Procedure

1. The provider begins by making an incision in the skin over the dislocated joint after the patient is appropriately prepped and anesthetized.
2. She then carefully dissects through the subcutaneous tissue, taking care to protect the nerves and vessels.
3. The provider retracts the muscles to gain adequate exposure of the dislocated bones.
4. Next, she adjusts the bones to reduce the dislocation, ensuring proper alignment.
5. If necessary, the provider may use implants like screws, nails, or wires to provide additional stability to the reduced joint.
6. Finally, she closes the wound by suturing the layers of the skin together.
7. The patient’s foot is then placed in a splint or brace 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 28585 is performed on patients with a talotarsal joint dislocation that requires open treatment. The procedure may or may not involve the use of internal fixation implants. The provider must carefully assess the patient’s condition and determine the need for this specific treatment. The dislocation must be located in the talotarsal joint, which is the joint between the talus bone and another tarsal bone.

5. When to use CPT code 28585

CPT code 28585 should be used when the provider performs open treatment of a talotarsal joint dislocation, including internal fixation if performed. This code is appropriate when the dislocation requires surgical intervention and the provider uses open techniques to reduce and stabilize the joint.

6. Documentation requirements

To support a claim for CPT 28585, the provider must document the following information:

• Patient’s diagnosis of talotarsal joint dislocation
• Details of the procedure performed, including the use of internal fixation 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 28585, ensure that the procedure performed is open treatment of a talotarsal joint dislocation, including internal fixation if performed. The use of internal fixation should be clearly documented in the medical record. It is important to follow the specific guidelines provided by the payer regarding the use of modifiers or additional documentation requirements.

8. Historical information

CPT 28585 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2008, the code description was updated to include the option of internal or external fixation for the treatment of talotarsal joint dislocation.

9. Examples

1. A podiatrist performs open treatment of a talotarsal joint dislocation, using internal fixation implants to stabilize the joint.
2. An orthopedic surgeon performs open reduction and internal fixation of a talotarsal joint dislocation in a patient who sustained a traumatic injury.
3. A foot and ankle specialist performs open treatment of a chronic talotarsal joint dislocation that has not responded to conservative management.
4. A pediatric orthopedic surgeon performs open reduction and internal fixation of a talotarsal joint dislocation in a child with a congenital deformity.
5. An orthopedic surgeon performs open treatment of a talotarsal joint dislocation in a patient with a history of recurrent dislocations.
6. A trauma surgeon performs open reduction and internal fixation of a talotarsal joint dislocation in a patient involved in a motor vehicle accident.
7. An orthopedic surgeon performs open treatment of a talotarsal joint dislocation in a patient with a sports-related injury.
8. A foot and ankle specialist performs open reduction and internal fixation of a talotarsal joint dislocation in a patient with a history of ankle instability.
9. An orthopedic surgeon performs open treatment of a talotarsal joint dislocation in a patient with a severe foot deformity.
10. A podiatrist performs open reduction and internal fixation of a talotarsal joint dislocation in a patient with a history of failed previous surgical interventions.