How To Use CPT Code 28735

CPT 28735 describes the surgical procedure known as arthrodesis, specifically for the midtarsal or tarsometatarsal joints. This article will provide an overview of CPT code 28735, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 28735?

CPT 28735 is a code used to describe a surgical procedure called arthrodesis. This procedure involves the surgical immobilization of multiple or transverse midtarsal or tarsometatarsal joints, along with an osteotomy to correct a flat foot deformity. The goal of this procedure is to alleviate pain in patients with end-stage osteoarthritis of the midtarsal or tarsometatarsal joints.

2. Official Description

The official description of CPT code 28735 is: ‘Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction).’ This code specifically refers to the surgical fusion of multiple or transverse midtarsal or tarsometatarsal joints, along with the performance of an osteotomy to correct a flat foot deformity.

3. Procedure

1. The surgical procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes an incision in the skin over the affected joints in the front of the ankle.
3. He then carefully dissects through the subcutaneous tissue, ensuring the preservation of nerves and veins.
4. The provider retracts the muscle to gain access to the joints that need to be fused.
5. Next, he incises the joint capsule and enters the joint, removing any dead or inflamed tissue from the joint cavity.
6. An osteotomy is performed, which involves the surgical removal of a portion of the shaft bone of the metatarsal bone to correct the flat foot deformity.
7. The bones of the joints are brought into close proximity and fused using implants such as K wires, screws, pins, or plates.
8. In some cases, a cancellous bone graft may be used to provide extra stability to the fused joints.
9. The provider stops any bleeding at the surgical site, irrigates the wound, and closes the wound by suturing the soft tissue in layers.
10. Finally, the ankle is placed in a cast or brace for a period of about four to six weeks to aid in the healing process.

4. Qualifying circumstances

CPT code 28735 is used for patients who have end-stage osteoarthritis of the midtarsal or tarsometatarsal joints and are experiencing significant pain. The procedure is performed by a qualified healthcare provider and involves the fusion of multiple or transverse joints, along with an osteotomy to correct a flat foot deformity.

5. When to use CPT code 28735

CPT code 28735 should be used when a patient requires surgical arthrodesis of multiple or transverse midtarsal or tarsometatarsal joints, along with an osteotomy to correct a flat foot deformity. It is important to note that this code should not be used when the provider performs arthrodesis without an osteotomy.

6. Documentation requirements

When reporting CPT code 28735, the healthcare provider must document the following information:

• Patient’s diagnosis of end-stage osteoarthritis of the midtarsal or tarsometatarsal joints
• Details of the surgical procedure performed, including the specific joints fused and the osteotomy performed
• Date of the surgery
• Any additional procedures or techniques used during the surgery
• Any complications or unexpected findings during the surgery
• Post-operative care instructions and follow-up plans
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 28735, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should use this code when performing arthrodesis of multiple or transverse midtarsal or tarsometatarsal joints, along with an osteotomy for flat foot correction. It is also important to follow any additional guidelines or requirements set forth by the payer or insurance company.

8. Historical information

CPT code 28735 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with end-stage osteoarthritis of the midtarsal joints undergoes arthrodesis of multiple joints, along with an osteotomy to correct a flat foot deformity.
2. A provider performs arthrodesis of the tarsometatarsal joints in a patient with significant pain due to end-stage osteoarthritis.
3. An individual with a flat foot deformity and severe pain undergoes arthrodesis of multiple midtarsal joints, along with an osteotomy for correction.
4. A patient with end-stage osteoarthritis of the tarsometatarsal joints undergoes surgical fusion of multiple joints, along with an osteotomy to alleviate pain and correct the flat foot deformity.
5. A provider performs arthrodesis of multiple midtarsal joints, along with an osteotomy, in a patient with debilitating pain and limited mobility.
6. An individual with a flat foot deformity and significant pain undergoes surgical fusion of multiple tarsometatarsal joints, along with an osteotomy for correction.