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Radical resection of a tumor in the tarsal region, excluding the talus or calcaneus, is a surgical procedure primarily indicated for the removal of malignant neoplasms. However, it may also be necessary for benign tumors or those of indeterminate nature. The procedure begins with the creation of a skin incision directly over the tumor site, or alternatively, a skin flap may be elevated to provide access. Once the incision is made, the surgeon meticulously dissects the overlying tissue to expose the tumor. The radical resection involves the complete removal of all bone and cartilage that is affected by the tumor, ensuring that the tumor is excised en bloc, which means the tumor is taken out in one piece along with a generous margin of healthy surrounding tissue. This approach is critical to minimize the risk of residual tumor cells remaining in the body. The resection of bone also necessitates the excision of all involved soft tissues, which can include muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues that are adjacent to the joints. To confirm that the surgical margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any margins are found to contain malignancy, further tissue removal is conducted until all margins are confirmed to be clear of tumor cells. After the tumor and surrounding tissues are removed, drains may be placed as necessary to prevent fluid accumulation. The surgical wound is typically closed in layers, and if required, additional reconstructive procedures may be performed to restore the area’s function and appearance. For coding purposes, the appropriate CPT® code for this procedure is 28171, while other codes are designated for metatarsal and phalanx of the toe procedures.
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Radical resection of a tumor in the tarsal region is indicated for the following conditions:
The procedure for radical resection of a tarsal tumor involves several critical steps:
Post-procedure care following a radical resection of a tarsal tumor includes monitoring for complications such as infection, bleeding, or fluid accumulation. Patients may require pain management and should be advised on activity restrictions to promote healing. Follow-up appointments are essential to assess recovery and ensure that no residual tumor cells remain. The surgical site should be kept clean and dry, and any drains placed during the procedure will need to be monitored and managed appropriately. Rehabilitation may be necessary to restore function and mobility in the affected area, depending on the extent of the resection and the patient's overall health status.
| Short Descr | RESECT TARSAL TUMOR | Medium Descr | RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS | Long Descr | Radical resection of tumor; tarsal (except 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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) | 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 | 142 - Partial excision bone |
| 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.) | LT | Left side (used to identify procedures performed on the left side of the body) |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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