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The CPT® Code 28100 refers to the excision or curettage of a bone cyst or benign tumor located in the talus or calcaneus, which are bones in the foot. A bone cyst is defined as a fluid-filled space within the bone, and it can be classified into various types. The unicameral or simple bone cyst is the most common type, characterized as a benign lesion that typically does not cause significant problems. In contrast, an aneurysmal bone cyst is less common and is composed of vascular tissue surrounding a blood-filled cystic lesion. Additionally, there are several types of benign bone tumors, including giant cell tumors, chondromyxoid fibromas, and enchondromas, which may also necessitate surgical intervention. In the procedure described by CPT® Code 28100, the surgeon makes an incision over the lesion site on the talus or calcaneus. The soft tissues are carefully dissected to expose the lesion. If a cystic lesion is identified, the surgeon incises the bone to create a window, allowing access to the cyst. The fluid within the cyst is aspirated and sent for laboratory analysis, which is reported separately. A curette is then inserted through the created window to completely remove the lining of the cystic cavity. In cases where a benign tumor is present, the procedure involves excising the tumor along with a margin of healthy bone to ensure complete removal. This surgical approach is critical for addressing both cystic lesions and benign tumors in the specified bones of the foot.
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The procedure described by CPT® Code 28100 is indicated for the treatment of specific conditions affecting the talus or calcaneus, particularly when a bone cyst or benign tumor is present. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 28100 involves several critical steps to ensure the effective removal of the bone cyst or benign tumor:
After the completion of the procedure, appropriate post-operative care is essential for optimal recovery. Patients may be monitored for any signs of complications, such as infection or excessive bleeding. Pain management strategies will be implemented to ensure patient comfort. The recovery period may vary depending on the extent of the surgery and the individual patient's health status. Follow-up appointments will be necessary to assess healing and to discuss any further treatment options if required. Additionally, patients may be advised on weight-bearing restrictions and rehabilitation exercises to restore function in the affected area.
| Short Descr | REMOVAL OF ANKLE/HEEL LESION | Medium Descr | EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS | Long Descr | Excision or curettage of bone cyst or benign tumor, talus or calcaneus; | 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) | 2 - Payment restriction for assistants at surgery does not apply 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 142 - Partial excision bone |
| 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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). | 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 | 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 | T9 | Right foot, fifth digit | 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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