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The procedure described by CPT® Code 28050 involves an arthrotomy with biopsy specifically targeting the intertarsal or tarsometatarsal joint. The intertarsal joints consist of the articulations between the seven tarsal bones, which include the talus, calcaneus, cuboid, navicular, and three cuneiform bones. These joints play a crucial role in foot mobility and stability. The tarsometatarsal joints are formed where the cuboid and the three cuneiform bones articulate with the metatarsal bones, connecting the midfoot to the forefoot. This procedure is performed to obtain tissue samples from the joint for diagnostic purposes, which may include evaluating for conditions such as arthritis, infection, or tumors. The surgical approach is determined by the specific joint being biopsied, and it involves careful dissection to expose the joint capsule, which is then opened to allow for the collection of tissue samples. These samples are subsequently sent for laboratory analysis, which is reported separately. The procedure concludes with the closure of the incision in layers and the application of a dressing to promote healing.
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The procedure is indicated for various conditions affecting the intertarsal or tarsometatarsal joints, which may include:
The procedure consists of several key steps, which are detailed as follows:
Post-procedure care involves monitoring the surgical site for signs of infection or complications. Patients are typically advised to rest and avoid putting weight on the affected foot for a specified period. Pain management may be necessary, and follow-up appointments are scheduled to review the biopsy results and assess the healing process. Additional rehabilitation or physical therapy may be recommended based on the findings and the patient's overall condition.
| Short Descr | BIOPSY OF FOOT JOINT LINING | Medium Descr | ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT | Long Descr | Arthrotomy with biopsy; intertarsal or tarsometatarsal joint | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | CCS Clinical Classification | 159 - Other diagnostic procedures on musculoskeletal system |
| 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). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | T1 | Left foot, second digit | T2 | Left foot, third digit | T5 | Right foot, great toe | 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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| Pre-1990 | Added | Code added. |
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