CPT® Code 0510T

Official Description

Removal of sinus tarsi implant

Common Language Description

The sinus tarsi is a small anatomical channel located between the talus and calcaneus bones, which are critical components of the ankle joint. This space plays a vital role in stabilizing the ankle by housing various structures that contribute to its function. In certain cases, particularly in patients with hyper-pronation of the foot, commonly referred to as flexible or mobile flatfoot, a sinus tarsi implant may be utilized. This implant serves to properly reposition the talus bone over the calcaneus bone, thereby limiting abnormal movements of the talus, a condition known as subtalar arthroereisis. The procedure for removing a sinus tarsi implant is indicated when a patient experiences significant pain or discomfort in the foot or ankle, which may arise from complications associated with the implant. The surgical approach involves making an incision on the lateral side of the hindfoot, directly over the sinus tarsi, followed by the careful debridement of scar tissue to expose the implant. Once the implant is accessible, it is grasped and removed, after which the incision is closed. This procedure is essential for alleviating pain and restoring function in patients who have undergone previous implantation.

1. Indications

The removal of a sinus tarsi implant is indicated in specific clinical scenarios where the patient experiences significant discomfort or complications related to the implant. The following conditions may warrant this procedure:

Excessive Pain The patient may report persistent or severe pain in the foot or ankle that is attributed to the sinus tarsi implant.
Discomfort Patients may experience ongoing discomfort that affects their mobility and quality of life, necessitating the removal of the implant.
Complications from the Implant Any complications arising from the implant, such as infection or improper positioning, may also indicate the need for removal.

2. Procedure

The procedure for the removal of a sinus tarsi implant involves several critical steps to ensure successful extraction and minimize complications. The following procedural steps are outlined:

Step 1: Incision The surgeon begins by making an incision on the lateral side of the hindfoot, directly over the sinus tarsi. This incision provides access to the implant and the surrounding anatomical structures.
Step 2: Debridement Once the incision is made, the surgeon carefully debrides the channel of any scar tissue that may have formed around the implant. This step is crucial for exposing the implant fully and ensuring that it can be grasped effectively.
Step 3: Implant Removal After the implant is exposed, the surgeon uses forceps or a clamp to grasp the implant securely. The implant is then removed from the channel, which may require careful manipulation to avoid damaging surrounding tissues.
Step 4: Closure Following the successful removal of the implant, the incision is closed using appropriate suturing techniques to promote healing and minimize scarring.

3. Post-Procedure

After the removal of the sinus tarsi implant, patients may require specific post-procedure care to ensure proper recovery. This may include monitoring for signs of infection at the incision site, managing pain with prescribed medications, and following up with physical therapy to restore mobility and strength in the affected foot. Patients are typically advised to avoid weight-bearing activities for a specified period to allow for adequate healing. The healthcare provider will provide detailed instructions regarding activity restrictions and any necessary follow-up appointments to assess the recovery process.

Short Descr	RMVL SINUS TARSI IMPLANT
Medium Descr	REMOVAL OF SINUS TARSI IMPLANT
Long Descr	Removal of sinus tarsi implant
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	T-Packaged Codes
ASC Payment Indicator	Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Berenson-Eggers TOS (BETOS)	none
MUE	1