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The CPT® Code 28043 refers to the excision of a tumor located in the soft tissue of the foot or toe, specifically when the tumor is subcutaneous and measures less than 1.5 cm in size. Soft tissues encompass a variety of structures, including subcutaneous fat, connective tissue, fascia, muscles, tendons, blood vessels, lymph vessels, nerves, and the tissues surrounding joints. Tumors that arise in these soft tissues can be either benign or malignant. Typically, benign tumors are treated through excision, while small malignant or indeterminate tumors may also be excised if they have well-defined margins. The procedure involves careful consideration of the tumor's location; the skin overlying the tumor may be incised directly, or a skin flap may be created and elevated to access the tumor. Once the overlying tissue is dissected, the soft tissue mass is exposed, allowing for the excision of the tumor along with a margin of healthy tissue to ensure complete removal. In some cases, a frozen section may be performed to verify that all margins are free of tumor cells, which is crucial for ensuring that the tumor has been completely excised. After the tumor removal, drains may be placed as necessary, and the surgical wound is typically closed in layers to promote proper healing. For coding purposes, it is important to distinguish between tumors based on their size and location; for instance, tumors in the subcutaneous fat or connective tissue that are less than 1.5 cm are coded with 28043, while larger tumors or those located below the fascia have different codes assigned for their excision.
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The procedure associated with CPT® Code 28043 is indicated for the excision of soft tissue tumors located in the foot or toe that are subcutaneous and measure less than 1.5 cm. The following conditions may warrant this procedure:
The procedure for excising a subcutaneous soft tissue tumor in the foot or toe involves several key steps, which are detailed below:
Post-procedure care for patients who have undergone excision of a subcutaneous soft tissue tumor includes monitoring for any signs of infection, managing pain, and ensuring proper wound care. Patients are typically advised to keep the surgical site clean and dry, and to follow any specific instructions provided by the surgeon regarding activity restrictions and follow-up appointments. Recovery time may vary depending on the individual and the extent of the procedure, but patients can generally expect to resume normal activities within a few days, barring any complications. It is important for patients to attend follow-up visits to monitor healing and to discuss any further treatment if necessary.
| Short Descr | EXC FOOT/TOE TUM SC < 1.5 CM | Medium Descr | EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM | Long Descr | Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm | Status Code | Active Code | Global Days | 090 - Major Surgery | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6B - Minor procedures - musculoskeletal | MUE | 4 | CCS Clinical Classification | 170 - Excision of skin lesion |
| LT | Left side (used to identify procedures performed on the left side of the body) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | T5 | Right foot, great toe | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | SA | Nurse practitioner rendering service in collaboration with a physician | SG | Ambulatory surgical center (asc) facility service | T1 | Left foot, second digit | T2 | Left foot, third digit | T3 | Left foot, fourth digit | T4 | Left foot, fifth digit | T6 | Right foot, second digit | T7 | Right foot, third digit | T8 | Right foot, fourth digit | T9 | Right foot, fifth digit | TA | Left foot, great toe | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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