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The procedure described by CPT® Code 28088 refers to a synovectomy of the extensor tendon sheath in the foot. A synovectomy is a surgical procedure aimed at removing the synovial membrane, which is the tissue that lines the joints and tendon sheaths. This procedure is typically indicated for patients suffering from inflammation of the synovial tissue, often due to conditions such as rheumatoid arthritis. The inflammation can lead to pain, swelling, and reduced mobility in the affected area. During the procedure, a surgical incision is made over the extensor tendon sheath, allowing access to the inflamed tissue. The surgeon carefully dissects the surrounding soft tissues to reach the tendon sheath, which is then incised to facilitate the removal of the inflamed synovial tissue. A motorized suction shaving device is often employed to ensure complete removal of the affected tissue, promoting healing and restoring function to the tendon. It is important to note that CPT® Code 28086 is used for synovectomy of a flexor tendon sheath, distinguishing it from the procedure associated with code 28088.
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The synovectomy of the extensor tendon sheath, as described by CPT® Code 28088, is indicated for the treatment of specific conditions that lead to inflammation of the synovial tissue. The following are the primary indications for this procedure:
The procedure for synovectomy of the extensor tendon sheath involves several critical steps to ensure effective removal of the inflamed tissue. The following outlines the procedural steps:
Following the synovectomy of the extensor tendon sheath, patients can expect specific post-procedure care and recovery considerations. It is essential to monitor the surgical site for signs of infection and to manage pain effectively. Patients are typically advised to rest the affected foot and may be instructed to use crutches or a walking boot to avoid putting weight on the foot during the initial recovery phase. Physical therapy may be recommended to restore mobility and strength in the tendon and surrounding structures. The expected recovery time can vary based on individual factors, but patients should follow their surgeon's guidelines for activity restrictions and rehabilitation to ensure optimal healing.
| Short Descr | EXCISE FOOT TENDON SHEATH | Medium Descr | SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR | Long Descr | Synovectomy, tendon sheath, foot; extensor | 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 | 2 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 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. | 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). | 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) | SG | Ambulatory surgical center (asc) facility service | T1 | Left foot, second digit | T4 | Left foot, fifth digit | T5 | Right foot, great toe | T6 | Right foot, second digit | T7 | Right foot, third digit | T9 | Right foot, fifth digit | TA | Left 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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