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Official Description

Tenolysis, flexor, foot; multiple tendons

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Tenolysis is a surgical procedure aimed at freeing a tendon from the surrounding tissue that may be restricting its movement. Specifically, CPT® Code 28222 refers to the tenolysis of multiple flexor tendons in the foot. This procedure is typically indicated when scar tissue has formed around the tendons due to trauma or a disease process, which can impede the normal range of motion of the foot and toes. The goal of tenolysis is to restore mobility by releasing these adhesions. The procedure involves making incisions over the affected tendons, carefully dissecting the soft tissues to access the tendons, identifying the affected tendons, and severing the adhesions that are causing the restriction. After the adhesions are released, the range of motion is evaluated to ensure that the procedure has been successful. Finally, the surgical wound is closed in layers, and a dressing is applied to protect the area during the initial healing phase.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Tenolysis, flexor, foot; multiple tendons (CPT® Code 28222) is indicated for patients experiencing restricted motion in the foot and/or toes due to the presence of scar tissue. This condition may arise from various factors, including:

  • Trauma - Injury to the foot that leads to the formation of adhesions around the flexor tendons.
  • Disease Process - Conditions such as diabetes or inflammatory diseases that can contribute to tendon scarring and adhesion formation.

2. Procedure

The procedure for tenolysis of multiple flexor tendons involves several key steps, which are detailed as follows:

  • Step 1: Incision - The surgeon begins by making incisions over the affected flexor tendons. These incisions are strategically placed to allow access to multiple tendons while minimizing tissue damage.
  • Step 2: Dissection - Once the incisions are made, the surgeon carefully dissects the surrounding soft tissues to expose the affected tendons. This step requires precision to avoid damaging nearby structures.
  • Step 3: Identification of Tendons - After the soft tissues are dissected, the surgeon identifies the specific flexor tendons that are affected by adhesions. This identification is crucial for the subsequent steps of the procedure.
  • Step 4: Severing Adhesions - The surgeon then proceeds to sever the adhesions that are restricting the movement of the tendons. This step is essential for restoring the normal function of the tendons.
  • Step 5: Range of Motion Evaluation - Following the release of the adhesions, the surgeon evaluates the range of motion of the foot and toes to assess the effectiveness of the procedure.
  • Step 6: Wound Closure - Finally, the surgical wound is closed in layers to promote proper healing. A dressing is then applied to protect the surgical site.

3. Post-Procedure

After the tenolysis procedure, patients can expect a recovery period that may involve monitoring for signs of infection and managing pain. The surgical site will require care to ensure proper healing, and patients may be advised on specific activities to avoid during the initial recovery phase. Physical therapy may also be recommended to help restore strength and flexibility in the foot and toes, facilitating a return to normal function.

Short Descr RELEASE OF FOOT TENDONS
Medium Descr TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS
Long Descr Tenolysis, flexor, foot; multiple tendons
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) 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) P5B - Ambulatory procedures - musculoskeletal
MUE 1
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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
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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