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Official Description

Open treatment of tarsal bone dislocation, includes internal fixation, when performed

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 28555 refers to the open treatment of a tarsal bone dislocation, which involves the surgical correction of a dislocated tarsal bone through an incision. Tarsal bones are a group of seven bones located in the foot, which include two posterior bones, the talus and calcaneus, and five anterior bones, namely the navicular, cuboid, and three cuneiform bones. In this procedure, the surgeon makes an incision over the affected joint to access the dislocated bone. The dislocation is then reduced, meaning the bone is repositioned back into its normal alignment. To ensure stability and proper healing, internal fixation devices such as pins or screws may be utilized. After the dislocation is corrected and any necessary fixation is applied, the surgical site is irrigated to prevent infection, and the incision is closed with sutures. This procedure is critical for restoring function and alleviating pain associated with tarsal bone dislocations.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of tarsal bone dislocation, as described by CPT® Code 28555, is indicated for specific conditions and symptoms that necessitate surgical intervention. These indications include:

  • Tarsal Bone Dislocation A dislocation of one or more of the tarsal bones, which may result from trauma or injury, leading to misalignment and potential loss of function.
  • Severe Pain Patients experiencing significant pain in the foot due to the dislocation that is not alleviated by conservative treatment methods.
  • Impaired Mobility Difficulty in walking or bearing weight on the affected foot, which may require surgical correction to restore normal function.
  • Joint Instability A feeling of instability in the affected joint, indicating that the dislocation has not resolved and may require surgical intervention for stabilization.

2. Procedure

The procedure for the open treatment of tarsal bone dislocation involves several critical steps to ensure proper alignment and stabilization of the affected bones. The steps include:

  • Step 1: Incision The surgeon begins by making a precise incision over the dislocated joint to gain access to the tarsal bones. This incision is strategically placed to minimize damage to surrounding tissues while providing adequate visibility and access to the dislocated area.
  • Step 2: Reduction of Dislocation Once access is obtained, the surgeon carefully manipulates the dislocated bone back into its correct anatomical position. This step, known as reduction, is crucial for restoring normal alignment and function to the joint.
  • Step 3: Internal Fixation After the dislocation is reduced, the surgeon may apply internal fixation devices, such as pins or screws, to stabilize the bone in its new position. This fixation is essential for maintaining alignment during the healing process and preventing future dislocations.
  • Step 4: Wound Irrigation Following the fixation, the surgical site is thoroughly irrigated to remove any debris and reduce the risk of infection. This step is vital for ensuring a clean environment for healing.
  • Step 5: Closure of Incision Finally, the incision is closed using sutures. The closure technique is performed carefully to promote optimal healing and minimize scarring.

3. Post-Procedure

After the open treatment of tarsal bone dislocation, patients can expect specific post-procedure care and considerations. It is essential to monitor the surgical site for signs of infection, such as increased redness, swelling, or discharge. Patients may be advised to keep the foot elevated to reduce swelling and to follow a prescribed rehabilitation program to regain strength and mobility. Pain management strategies will also be discussed, and follow-up appointments will be scheduled to assess healing and the effectiveness of the internal fixation. The recovery period may vary depending on the severity of the dislocation and the individual patient's healing process.

Short Descr REPAIR FOOT DISLOCATION
Medium Descr OPEN TREATMENT TARSAL BONE DISLOCATION
Long Descr Open treatment of tarsal bone dislocation, includes internal fixation, when performed
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) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
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).
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.
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.
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
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
T5 Right foot, great toe
T8 Right foot, fourth digit
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
Date
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Notes
2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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