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The procedure described by CPT® Code 28153 involves the surgical resection of the condyle(s) at the distal end of the phalanx for each toe. This procedure is typically indicated for conditions that affect the joint structure of the toes, potentially leading to pain, deformity, or impaired function. The surgery begins with a longitudinal incision made over the affected phalanx, allowing access to the underlying joint capsule. The joint capsule is then incised, and a capsular flap is created to facilitate the exposure of the distal aspect of the phalanx. During the procedure, the medial and/or lateral condyle is excised, which may involve removing any redundant tissue from the joint capsule or plicating it to ensure proper closure. The final steps involve closing the overlying soft tissues in layers to promote healing. It is important to report code 28153 for each toe on which the resection of the condyles is performed, ensuring accurate documentation and billing for the surgical intervention.
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The procedure described by CPT® Code 28153 is indicated for various conditions affecting the toes, particularly those that involve the joint structure and may lead to pain or functional impairment. Common indications for this procedure include:
The procedure for CPT® Code 28153 involves several key steps that ensure effective resection of the condyle(s) at the distal end of the phalanx. The first step is to make a longitudinal incision over the affected phalanx, which provides direct access to the underlying structures. Following the incision, the joint capsule is carefully incised, and a capsular flap is created. This flap is essential for exposing the distal aspect of the phalanx, where the surgical intervention will take place. Once the area is adequately exposed, the surgeon excises the medial and/or lateral condyle, depending on the specific requirements of the case. After the condyle resection, any redundancy in the joint capsule is addressed; this may involve excising excess tissue or plicating the capsule to ensure it is properly aligned and secured. Finally, the overlying soft tissues are closed in layers, which is crucial for promoting healing and restoring the integrity of the toe structure. It is important to report code 28153 for each toe on which the condyle resection is performed, ensuring accurate coding and billing for the surgical procedure.
Post-procedure care following the resection of the condyle(s) at the distal end of the phalanx is essential for optimal recovery. Patients are typically advised to keep the affected toe elevated to reduce swelling and promote healing. Pain management may be necessary, and patients may be prescribed analgesics to manage discomfort during the recovery period. It is also important for patients to follow any specific instructions regarding wound care to prevent infection and ensure proper healing of the incision site. Physical therapy may be recommended to restore mobility and strength in the toe after the surgical intervention. Follow-up appointments are crucial to monitor the healing process and address any complications that may arise. Overall, adherence to post-procedure guidelines is vital for achieving the best possible outcomes following the surgery.
| Short Descr | PARTIAL REMOVAL OF TOE | Medium Descr | RESECTION CONDYLE DISTAL END PHALANX EACH TOE | Long Descr | Resection, condyle(s), distal end of phalanx, each toe | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | 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 | 4 | CCS Clinical Classification | 142 - Partial excision bone |
| 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). | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | F4 | Left hand, fifth digit | F9 | Right hand, fifth 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 | T3 | Left foot, fourth digit | T4 | Left foot, fifth digit | T5 | Right foot, great toe | 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 | 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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