How To Use CPT Code 28740

CPT 28740 describes the surgical procedure of arthrodesis on a single midtarsal or tarsometatarsal joint. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28740?

CPT 28740 is used to describe a surgical procedure in which a single midtarsal or tarsometatarsal joint is immobilized using fixation devices. This procedure is performed to treat pain in patients with end-stage osteoarthritis of the midtarsal or tarsometatarsal joints. The goal of the procedure is to fuse the joint, providing stability and relieving pain for the patient.

2. Official Description

The official description of CPT code 28740 is: ‘Arthrodesis, midtarsal or tarsometatarsal, single joint.’

3. Procedure

1. The provider begins by making an incision in the skin over the affected joint in front of the ankle.
2. They then dissect through the subcutaneous tissue, being careful to preserve the nerves and veins.
3. The provider retracts the muscle to gain access to the joint that needs to be fused.
4. Next, they cut the joint capsule and enter the joint.
5. Any dead or inflamed tissue within the joint cavity is removed.
6. The provider brings the bones of the joint in close proximity and fuses the joint using fixation devices such as K-wires, screws, or plates.
7. In some cases, a cancellous bone graft may be used to provide additional stability.
8. The provider ensures hemostasis at the surgical site and closes the wound by suturing the soft tissue layers.
9. Finally, the patient’s ankle is placed in a cast or brace for a period of four to six weeks to aid in the healing process.

4. Qualifying circumstances

CPT 28740 is performed on patients with end-stage osteoarthritis of the midtarsal or tarsometatarsal joints. The procedure is indicated when conservative treatments have failed to provide relief from pain and the patient’s quality of life is significantly affected. The decision to perform arthrodesis is made after careful evaluation of the patient’s condition and consideration of other treatment options.

5. When to use CPT code 28740

CPT code 28740 should be used when a provider performs arthrodesis on a single midtarsal or tarsometatarsal joint. It is important to accurately document the specific joint that was fused to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 28740, the provider must document the following information:

• Patient’s diagnosis of end-stage osteoarthritis of the midtarsal or tarsometatarsal joint
• Details of the surgical procedure, including the specific joint fused
• Implants used for fixation, such as K-wires, screws, or plates
• Use of cancellous bone graft, if applicable
• Date of the procedure
• Any additional procedures performed during the same surgical session
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 28740, ensure that the procedure was performed on a single midtarsal or tarsometatarsal joint. It is important to accurately document the specific joint fused to support the claim. There are no specific guidelines regarding reporting CPT 28740 with other codes, but it is important to follow any applicable bundling or unbundling rules.

8. Historical information

CPT 28740 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 joint undergoes arthrodesis of the joint to relieve pain and improve mobility.
2. A provider performs arthrodesis on a single tarsometatarsal joint in a patient with severe osteoarthritis, aiming to alleviate pain and stabilize the joint.
3. Arthrodesis is performed on a midtarsal joint in a patient with advanced osteoarthritis, helping to reduce pain and improve function.
4. A provider fuses a single tarsometatarsal joint in a patient with debilitating osteoarthritis, aiming to restore stability and alleviate pain.
5. Arthrodesis is performed on a midtarsal joint in a patient with chronic osteoarthritis, aiming to improve their quality of life by reducing pain and increasing joint stability.
6. A provider performs arthrodesis on a single tarsometatarsal joint in a patient with end-stage osteoarthritis, aiming to provide long-term pain relief and improve joint function.
7. Arthrodesis is performed on a midtarsal joint in a patient with severe osteoarthritis, aiming to restore joint stability and alleviate pain.
8. A provider fuses a single tarsometatarsal joint in a patient with advanced osteoarthritis, aiming to improve their mobility and reduce pain.
9. Arthrodesis is performed on a midtarsal joint in a patient with debilitating osteoarthritis, aiming to restore joint function and alleviate pain.