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Syndactyly is a congenital condition characterized by the fusion of two or more toes in the foot. This condition can manifest in two primary forms: simple and complex syndactyly. Simple syndactyly involves only the soft tissues connecting the toes, while complex syndactyly includes additional involvement of bone, cartilage, or nails. The surgical procedure described by CPT® Code 28345 addresses the reconstruction of the toes affected by syndactyly, which may involve the use of skin grafts. The goal of the procedure is to separate the conjoined toes, restore normal anatomy, and ensure proper function and appearance. The surgical approach includes careful dissection of the soft tissues, preservation of blood supply, and, when necessary, the application of skin grafts to achieve optimal closure of the incisions. This procedure is essential for improving the quality of life for individuals with syndactyly, allowing for better mobility and foot function.
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The procedure described by CPT® Code 28345 is indicated for the treatment of syndactyly in the toes. The specific indications include:
The procedure for reconstructing syndactyly in the toes involves several detailed steps, which are as follows:
After the procedure, patients are typically monitored for any immediate complications. Post-operative care may include pain management, wound care instructions, and follow-up appointments to assess healing. Patients are advised on activity restrictions to promote proper recovery and prevent complications. The expected recovery time may vary depending on the complexity of the procedure and the individual patient's healing process. It is essential to follow the surgeon's recommendations for optimal outcomes.
| Short Descr | REPAIR WEBBED TOE(S) | Medium Descr | RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB | Long Descr | Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web | 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) | 0 - 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 | 2 | CCS Clinical Classification | 143 - Bunionectomy or repair of toe deformities |
| 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). | 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. | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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