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The procedure described by CPT® Code 28288 involves an ostectomy, specifically a partial exostectomy or condylectomy of the metatarsal head. This surgical intervention is performed on the metatarsal head, which is the rounded end of the metatarsal bone that articulates with the proximal phalanx of the toe. The procedure typically begins with an incision made over the metatarsophalangeal joint, which is the joint connecting the metatarsal bone to the toe. Following the incision, the surgeon dissects the soft tissues to expose the joint capsule, ensuring that the underlying structures are accessible for the procedure. During the surgery, tendons and neurovascular structures are carefully retracted and protected to prevent any damage. The soft tissue attachments at the metatarsal head are mobilized to allow for better access to the bone. Once the metatarsal head is fully exposed, any bony exostoses, which are abnormal bony growths, are excised. In cases where a condylectomy is indicated, a sagittal saw is utilized to remove the bony prominences effectively. After the excision, the bone surface is smoothed using a rasp to ensure proper healing and function. Finally, the incision is closed in layers to promote optimal recovery and minimize complications. This procedure is typically indicated for conditions that cause pain or dysfunction in the metatarsophalangeal joint, often due to bony growths or deformities.
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The procedure described by CPT® Code 28288 is indicated for various conditions affecting the metatarsal head, particularly when there is the presence of bony growths or deformities that cause pain or functional impairment. The following are specific indications for performing this procedure:
The procedure involves several critical steps to ensure effective treatment of the metatarsal head. Each step is designed to provide access to the affected area while minimizing trauma to surrounding tissues.
Post-procedure care following an ostectomy, partial exostectomy, or condylectomy of the metatarsal head is essential for ensuring proper recovery. Patients are typically advised to rest and elevate the affected foot to minimize swelling. Pain management may be necessary, and the use of ice packs can help reduce inflammation. Weight-bearing activities may be restricted for a specified period, depending on the extent of the surgery and the surgeon's recommendations. Follow-up appointments are crucial to monitor the healing process and to assess for any complications. Patients should be educated on signs of infection or other issues that may arise during recovery, such as increased pain or swelling. Rehabilitation exercises may be introduced gradually to restore mobility and strength to the foot as healing progresses.
| Short Descr | PARTIAL REMOVAL OF FOOT BONE | Medium Descr | OSTC PRTL EXOSTC/CONDYLC METAR HEAD | Long Descr | Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head | 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 |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. | 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 | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F7 | Right hand, third digit | F8 | Right hand, fourth digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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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