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The procedure described by CPT® Code 28055 refers to a neurectomy performed on the intrinsic musculature of the foot. A neurectomy is a surgical procedure that involves the removal of a segment of a nerve, which is typically indicated to alleviate pain or discomfort caused by nerve entrapment or irritation. In this specific case, the procedure targets the intrinsic muscles of the foot, which are responsible for various movements and stability of the toes. The surgery is conducted under magnification to enhance precision and minimize damage to surrounding tissues. A straight midline incision is made on the dorsal aspect of the foot, specifically in the web space between the metatarsal bones. This incision allows access to the underlying structures, where the surgeon dissects through the tissue down to the fascia, identifying and dividing the transverse metatarsal ligament. The metatarsal heads are then manipulated to expose the nerve, which is carefully dissected to its bifurcation. If present, any inflamed bursa may also be excised during the procedure. The ultimate goal of the neurectomy is to sever the nerve's connection to the muscle tissue, thereby interrupting the transmission of electrical impulses that may be causing pain or dysfunction. After the nerve is removed, the surgical site is meticulously cleaned and repaired to promote optimal healing.
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The neurectomy of the intrinsic musculature of the foot, as described by CPT® Code 28055, is typically indicated for the following conditions:
The procedure for a neurectomy of the intrinsic musculature of the foot involves several critical steps, each designed to ensure precision and effectiveness in addressing the underlying issue.
Post-procedure care following a neurectomy of the intrinsic musculature of the foot typically involves monitoring for any signs of complications, such as infection or excessive swelling. Patients may be advised to keep the surgical site clean and dry, and to follow specific instructions regarding activity levels to ensure proper healing. Pain management may be addressed with prescribed medications, and follow-up appointments will be necessary to assess recovery and the effectiveness of the procedure. Patients should be informed about potential changes in sensation in the foot and any expected outcomes related to pain relief and functional improvement.
| Short Descr | NEURECTOMY FOOT | Medium Descr | NEURECTOMY INTRINSIC MUSCULATURE OF FOOT | Long Descr | Neurectomy, intrinsic musculature of foot | 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) | 0 - 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 | 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 | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| 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. | 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. | 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. | 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). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F2 | Left hand, third digit | F5 | Right hand, thumb | F8 | Right hand, fourth digit | 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) | SG | Ambulatory surgical center (asc) facility service | T1 | Left foot, second digit | T2 | Left foot, third digit | T6 | Right foot, second digit | T7 | Right foot, third digit | TA | Left foot, great toe | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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