How To Use CPT Code 28890

CPT 28890 describes a procedure involving the use of high energy sound waves to stimulate healing of the plantar fascia, which is the thick band of connective tissue that supports the arch of the foot. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28890?

CPT 28890 is a code used to describe a procedure performed by a physician or other qualified healthcare professional. This procedure involves the use of high energy sound waves to stimulate healing of the plantar fascia, which is the thick band of connective tissue that supports the arch of the foot. The procedure requires anesthesia other than local and includes ultrasound guidance to ensure accurate targeting of the treatment area.

2. Official Description

The official description of CPT code 28890 is: ‘Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia.’

3. Procedure

1. The patient is appropriately prepped and anesthetized, either under regional or general anesthesia, due to the painful nature of the treatment.
2. The healthcare professional uses an extracorporeal shock wave therapy device to administer high energy sound waves directly to the skin of the foot over the plantar fascia.
3. Ultrasound guidance is utilized to aid in directing the high energy sound waves to their target, ensuring accurate treatment.

4. Qualifying circumstances

CPT 28890 is performed on patients with plantar fasciitis, a condition characterized by inflammation and pain in the connective tissue supporting the arch of the foot. The procedure is performed by a physician or other qualified healthcare professional and requires anesthesia other than local. Ultrasound guidance is used to ensure precise targeting of the treatment area.

5. When to use CPT code 28890

CPT code 28890 should be used when a physician or other qualified healthcare professional performs the procedure involving the use of high energy sound waves to stimulate healing of the plantar fascia. It is important to note that this code should only be reported if the procedure is performed under general or regional anesthesia.

6. Documentation requirements

To support a claim for CPT 28890, the healthcare professional must document the following information:

• Patient’s diagnosis of plantar fasciitis
• Type of anesthesia administered (regional or general)
• Date and time of the procedure
• Use of ultrasound guidance

7. Billing guidelines

When billing for CPT 28890, ensure that the procedure is performed by a physician or other qualified healthcare professional and that anesthesia other than local is used. It is important to note that CPT code 28890 should not be reported in conjunction with codes 0512T or 0513T when treating the same area. Additionally, diagnostic ultrasound services performed prior to or subsequent to the procedure may be separately reportable, so it is essential to check payer and coding guidelines.

8. Historical information

CPT code 28890 was added to the Current Procedural Terminology system on January 1, 2006. The code underwent a change on January 1, 2013, with the inclusion of ‘performed by a physician’ in the official description.

9. Examples

1. A physician performing CPT 28890 to administer high energy sound waves to the plantar fascia of a patient with severe plantar fasciitis.
2. A qualified healthcare professional using ultrasound guidance to direct high energy sound waves to the skin of the foot over the plantar fascia during CPT 28890 for a patient with chronic foot pain.
3. A physician performing CPT 28890 under regional anesthesia to stimulate healing of the plantar fascia in a patient with recurrent plantar fasciitis.
4. A qualified healthcare professional utilizing extracorporeal shock wave therapy to treat plantar fasciitis in a patient who has not responded to conservative treatments.
5. A physician performing CPT 28890 on a patient with severe plantar fasciitis to alleviate pain and promote healing of the plantar fascia.
6. A qualified healthcare professional using ultrasound guidance to accurately target the plantar fascia during CPT 28890 for a patient with chronic foot pain.
7. A physician administering high energy sound waves to the plantar fascia of a patient with persistent plantar fasciitis during CPT 28890.
8. A qualified healthcare professional performing CPT 28890 to stimulate healing of the plantar fascia in a patient with debilitating foot pain.
9. A physician utilizing extracorporeal shock wave therapy to treat plantar fasciitis in a patient who has failed to respond to conservative treatments during CPT 28890.
10. A qualified healthcare professional performing CPT 28890 under regional anesthesia to alleviate pain and promote healing of the plantar fascia in a patient with chronic foot pain.