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The procedure described by CPT® Code 28496 involves the percutaneous skeletal fixation of a fracture in the great toe, specifically targeting the phalanx or phalanges. This technique is utilized when there is a fracture in the bone structure of the great toe, which may result from trauma or injury. The term 'percutaneous' indicates that the procedure is performed through the skin, minimizing the need for larger incisions and thereby reducing recovery time and potential complications associated with open surgery. The process begins with a small incision made proximal to the fracture site, allowing access to the underlying bone without extensive disruption of surrounding tissues. A specialized drill is then employed to create a corticotomy, which is a surgical procedure that involves cutting the outer layer of the bone to facilitate the alignment and stabilization of the fracture. Following this, the fracture is carefully reduced, meaning that the bone fragments are realigned to their normal anatomical position. To secure the fracture, one or more pre-bent Kirschner wires are inserted through the medullary canal, which is the central cavity of the bone. If the injury involves both phalanges of the great toe, the wires are advanced through both the proximal and distal phalanges to ensure adequate stabilization. The success of the procedure is confirmed through radiographic imaging, which allows for the verification of proper anatomical reduction and alignment of the fractured bones.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 28496 is indicated for specific conditions related to fractures of the great toe. The following are the primary indications for performing this procedure:
The procedure for CPT® Code 28496 involves several critical steps to ensure effective fixation of the fracture. The following outlines the procedural steps:
After the completion of the procedure, appropriate post-operative care is essential for optimal recovery. Patients may be monitored for any signs of complications, such as infection or improper healing. Pain management strategies will be implemented to ensure patient comfort. The patient may be advised to limit weight-bearing activities on the affected toe for a specified period to promote healing. Follow-up appointments will be necessary to assess the healing process through radiographic imaging and to remove any fixation devices, such as the Kirschner wires, once adequate healing has occurred. Rehabilitation exercises may also be recommended to restore mobility and strength to the toe as part of the recovery process.
| Short Descr | TREAT BIG TOE FRACTURE | Medium Descr | PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ | Long Descr | Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation | 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) | P6B - Minor procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FA | Left hand, thumb | 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 | T2 | Left foot, third digit | T5 | Right foot, great toe | TA | Left foot, great toe |
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| Pre-1990 | Added | Code added. |
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