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Reconstruction of an angular deformity of the toe involving only soft tissue is a surgical procedure aimed at correcting deformities such as overlapping second toes, fifth toes, or curly toes. This procedure is specifically indicated when the deformity does not involve any bony abnormalities, focusing solely on the soft tissue structures. The surgical approach begins with a skin incision made over the affected toe, allowing access to the underlying soft tissues. During the procedure, the surgeon carefully dissects the soft tissues to identify the specific structures that are contributing to the angular deformity. Depending on the nature of the deformity, various techniques may be employed, including incising and lengthening the extensor tendon, opening the joint capsule, or releasing the flexor tendon. After the necessary corrections are made to restore the toe's proper alignment, the surgeon meticulously repairs the overlying soft tissue and skin in layers to ensure optimal healing. Finally, the toe is splinted to maintain its corrected position during the healing process, which is crucial for achieving a successful outcome.
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The reconstruction of an angular deformity of the toe is indicated for specific conditions that involve soft tissue abnormalities without any bony involvement. The following are the primary indications for this procedure:
The procedure for reconstructing an angular deformity of the toe involves several critical steps to ensure effective correction of the deformity. Each step is designed to address the specific soft tissue components contributing to the condition.
Post-procedure care is essential for ensuring optimal recovery following the reconstruction of an angular deformity of the toe. Patients are typically advised to keep the toe elevated to reduce swelling and to follow specific instructions regarding splint care. It is important to monitor the surgical site for any signs of infection or complications. Patients may also be instructed to avoid putting weight on the affected toe for a designated period to allow for proper healing. Follow-up appointments are crucial to assess the healing process and to make any necessary adjustments to the treatment plan. Overall, adherence to post-procedure guidelines is key to achieving a successful outcome and restoring normal function to the toe.
| Short Descr | REPAIR DEFORMITY OF TOE | Medium Descr | RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY | Long Descr | Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes) | 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 | 143 - Bunionectomy or repair of toe deformities |
| 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. | T6 | Right foot, second digit | T1 | Left foot, second digit | 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). | T2 | Left foot, third digit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | LT | Left side (used to identify procedures performed on the left side of the body) | 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.) | RT | Right side (used to identify procedures performed on the right side of the body) | T9 | Right foot, fifth digit | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | T4 | Left foot, fifth digit | T3 | Left foot, fourth digit | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | AG | Primary physician | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F4 | Left hand, fifth digit | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | KW | Dmepos item subject to dmepos competitive bidding program number 4 | SG | Ambulatory surgical center (asc) facility service | T5 | Right foot, great toe | T7 | Right foot, third digit | T8 | Right foot, fourth digit | TA | Left foot, great toe | TD | Rn | TL | Early intervention/individualized family service plan (ifsp) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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