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The procedure described by CPT® Code 28546 refers to the percutaneous skeletal fixation of a dislocated tarsal bone, excluding the talotarsal joint. This surgical intervention is performed to restore the proper alignment of the tarsal bones, which are located in the midfoot and play a crucial role in foot stability and mobility. The process begins with a small incision made over the affected tarsal joint, allowing access to the dislocated bones. The surgeon then manipulates the dislocated bones back into their correct anatomical position, a process known as reduction. To confirm that the bones are properly aligned, radiographs (X-rays) are taken, which are reportable separately from the procedure itself. Following the reduction, additional small incisions are made at the sites where pins or Kirschner wires will be inserted. A specialized drill is utilized to create a corticotomy, which is a small opening in the bone, facilitating the insertion of the fixation devices. The pins or wires are then carefully advanced through one of the involved tarsal bones, across the joint, and into the adjacent tarsal bone, effectively stabilizing the joint and maintaining the alignment achieved during the reduction. After the placement of all fixation devices, another set of radiographs is performed to ensure that the anatomical reduction has been successfully maintained. This procedure is critical for preventing complications associated with dislocated tarsal bones, such as chronic pain, instability, and impaired function of the foot.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 28546 is indicated for the treatment of dislocations of the tarsal bones, excluding the talotarsal joint. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 28546 involves several critical steps to ensure the successful fixation of the dislocated tarsal bones:
After the completion of the procedure, patients may require specific post-operative care to ensure optimal recovery. This may include monitoring for signs of infection at the incision sites, managing pain with prescribed medications, and following up with radiographs to assess the stability of the fixation. Patients are typically advised to limit weight-bearing activities on the affected foot for a specified period, allowing for proper healing of the tarsal bones. Rehabilitation exercises may be introduced gradually to restore strength and mobility as healing progresses. It is essential for patients to adhere to their surgeon's post-operative instructions to achieve the best possible outcomes.
| Short Descr | TREAT FOOT DISLOCATION | Medium Descr | PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ | Long Descr | Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, 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) | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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.) | 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) | 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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