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The procedure described by CPT® Code 28576 refers to the percutaneous skeletal fixation of a dislocated talotarsal joint, which is a critical intervention for restoring proper alignment and stability to the joint. The talotarsal joint, also known as the subtalar joint, is located between the talus and the tarsal bones of the foot. Dislocation of this joint can result from trauma or injury, leading to significant pain, instability, and impaired function of the foot. The procedure involves making a small incision over the dislocated joint to allow for direct access to the affected area. Through this incision, the dislocated tarsal bones are carefully manipulated back into their correct anatomical position, a process known as reduction. To ensure that the bones are properly aligned, radiographs, or X-rays, are taken before and after the manipulation. Following the reduction, additional small incisions are made at the sites where pins or Kirschner wires will be inserted. A specialized drill is used to create a corticotomy, which is a small opening in the bone, facilitating the placement of these fixation devices. The pins or wires are then advanced through the talus and into the tarsal bone, effectively stabilizing the joint and preventing further dislocation. After the fixation devices are in place, another set of radiographs is performed to confirm that the anatomical reduction has been successfully achieved. This procedure is essential for restoring function and alleviating pain in patients with talotarsal joint dislocations.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 28576 is indicated for patients experiencing a dislocation of the talotarsal joint. This condition may arise due to various factors, including trauma, sports injuries, or accidents that result in significant displacement of the tarsal bones. The primary symptoms prompting this procedure typically include:
The procedure for CPT® Code 28576 involves several critical steps to ensure effective stabilization of the dislocated talotarsal joint. The steps are as follows:
Post-procedure care following the percutaneous skeletal fixation of the talotarsal joint dislocation is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies may be implemented to alleviate discomfort during the initial recovery phase. Patients are often advised to limit weight-bearing activities on the affected foot for a specified period, allowing the joint to heal properly. Follow-up appointments are crucial for assessing the healing process and ensuring that the fixation devices remain in place. Additional imaging may be required to confirm the stability of the joint as it heals. Rehabilitation exercises may be introduced gradually to restore mobility and strength to the foot once the initial healing has occurred.
| Short Descr | TREAT FOOT DISLOCATION | Medium Descr | PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ | Long Descr | Percutaneous skeletal fixation of talotarsal joint dislocation, 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 | 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 | 1 | CCS Clinical Classification | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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. | 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.) | 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 |
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| 1993-01-01 | Added | First appearance in code book in 1993. |
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