How To Use CPT Code 28805

CPT 28805 describes the surgical procedure known as transmetatarsal amputation of the foot. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28805?

CPT 28805 is used to describe the surgical removal of the front portion of the foot by cutting it across the metatarsal bones. The metatarsals are the long bones located between the tarsal bones of the foot/ankle and the phalanges of the toes. This procedure is known as transmetatarsal amputation.

2. Official Description

The official description of CPT code 28805 is: ‘Amputation, foot; transmetatarsal.’

3. Procedure

1. During the transmetatarsal amputation procedure, the provider begins by making an incision around the base of the toes in a circumferential manner, extending over to the metatarsal.
2. Next, the provider creates a long skin flap that will be used to cover the stump after the amputation.
3. The dorsalis pedis artery, which supplies oxygenated blood to the upper surface of the foot, is ligated by the provider.
4. The provider then retracts the nerves and transects and divides the tendons of the foot’s muscles.
5. If necessary, the provider may lengthen and transfer some muscles.
6. Finally, the provider cuts the foot through the metatarsal bones transversally, removing the front portion of the foot. The wound is closed by suturing the flaps, and antiseptic gauze is used to pack the wound.

4. Qualifying circumstances

CPT 28805 is performed when there is a need for the surgical removal of the front portion of the foot due to various medical conditions or injuries. This procedure is typically indicated when other treatment options have been exhausted or are not suitable for the patient. The provider must assess the patient’s condition and determine that a transmetatarsal amputation is the most appropriate course of action.

5. When to use CPT code 28805

CPT code 28805 should be used when the provider performs a transmetatarsal amputation of the foot. It is important to ensure that the procedure is accurately documented and meets the criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 28805, the provider must document the following information:

• Patient’s diagnosis or medical condition necessitating the transmetatarsal amputation
• Details of the surgical procedure, including the incision, creation of skin flaps, ligation of the dorsalis pedis artery, transection of tendons, and removal of the front portion of the foot
• Any additional procedures performed during the same surgical session
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 28805, ensure that the documentation supports the performance of a transmetatarsal amputation. It is important to follow the specific guidelines provided by the payer and accurately report the procedure code on the claim form. Additionally, consider any applicable modifiers or additional codes that may be required for proper reimbursement.

8. Historical information

CPT 28805 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 severe peripheral vascular disease undergoes a transmetatarsal amputation of the foot to alleviate chronic pain and improve blood flow.
2. An individual with a traumatic injury to the foot requires a transmetatarsal amputation to remove damaged tissue and promote healing.
3. A patient with a non-healing foot ulcer undergoes a transmetatarsal amputation to prevent the spread of infection and facilitate wound healing.
4. A person with a malignant tumor in the foot undergoes a transmetatarsal amputation as part of their cancer treatment plan.
5. An individual with a congenital foot deformity undergoes a transmetatarsal amputation to improve their mobility and quality of life.