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Radical resection of a tumor in the metatarsal region is a surgical procedure primarily indicated for the removal of malignant neoplasms, although it may also be necessary for benign tumors or tumors of indeterminate nature. This procedure involves a comprehensive approach to ensure complete excision of the tumor along with a significant margin of healthy tissue to minimize the risk of residual cancerous cells. The process begins with a skin incision made directly over the tumor site, or alternatively, a skin flap may be created and elevated to provide better access. Once the overlying tissue is carefully dissected, the tumor is exposed for removal. The radical resection entails excising not only the tumor itself but also all associated bone and cartilage that show signs of tumor involvement. This extensive removal includes all affected soft tissues, which may encompass muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints. To ensure that the surgical margins are clear of malignancy, a frozen section analysis is performed during the procedure. If any margins are found to contain tumor cells, further tissue is excised until all margins are confirmed to be free of malignancy. Post-surgery, drains may be placed as necessary to manage fluid accumulation, and the surgical wound is typically closed in layers. In some cases, additional reconstructive procedures may be required and reported separately. For coding purposes, it is important to note that specific codes are designated for different types of bone tumor resections, such as code 28171 for tarsal bones excluding the talus or calcaneus, code 28173 for metatarsal tumors, and code 28175 for phalanx of the toe.
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Radical resection of a tumor in the metatarsal area is indicated for the following conditions:
The procedure for radical resection of a metatarsal tumor involves several critical steps:
After the radical resection procedure, patients can expect a recovery period that may vary based on the extent of the surgery and individual health factors. Post-operative care typically includes monitoring for signs of infection, managing pain, and ensuring proper wound healing. Patients may be advised to limit weight-bearing activities on the affected foot to facilitate healing. Follow-up appointments are essential to assess recovery progress and to conduct any necessary additional treatments based on the pathology results from the excised tumor. Rehabilitation may also be recommended to restore function and mobility in the foot following the surgery.
| Short Descr | RESECT METATARSAL TUMOR | Medium Descr | RADICAL RESECTION TUMOR METATARSAL | Long Descr | Radical resection of tumor; metatarsal | 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) | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | 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.) | 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) | T1 | Left foot, second digit | T2 | Left foot, third digit | T4 | Left foot, fifth digit | 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 |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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