© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 28737 refers to an arthrodesis, specifically involving tendon lengthening and advancement at the midtarsal region, targeting the tarsal navicular-cuneiform joint. This surgical intervention is primarily indicated for addressing malalignment or sagging of the navicular-cuneiform joint, conditions that are frequently associated with flatfoot deformity or severe pronation. The arthrodesis aims to fuse the affected bones, thereby stabilizing the joint and alleviating pain or dysfunction. The procedure involves a careful surgical approach, beginning with an incision over the midfoot, followed by meticulous dissection of soft tissues to safeguard surrounding nerves and blood vessels. The surgical team exposes the midtarsal and tarsal navicular-cuneiform joints, excising cartilage and scaling bone to reveal the underlying cancellous bone. A key component of this procedure is the lengthening and advancement of the tibialis anterior tendon, which is achieved through a specific technique known as the Miller type procedure. This involves creating a Z-shaped incision in the tendon, allowing for its elongation and subsequent advancement to improve foot alignment. The surgical process also includes the repositioning of the midtarsal, navicular, and cuneiform bones to their anatomical positions, stabilization of the joints with pins or screws, and closure of the incisions in layers. Postoperatively, a bulky dressing is applied, and the foot is immobilized in a cast, splint, or boot to facilitate healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The arthrodesis procedure described by CPT® Code 28737 is indicated for the following conditions:
The procedure for CPT® Code 28737 involves several critical steps to ensure successful arthrodesis with tendon lengthening and advancement:
Post-procedure care for patients undergoing arthrodesis with tendon lengthening and advancement includes monitoring for signs of infection, managing pain, and ensuring proper immobilization of the foot. Patients are typically advised to keep the foot elevated and to follow specific weight-bearing restrictions as directed by the surgeon. Rehabilitation may involve physical therapy to restore mobility and strength once the initial healing phase has passed. The duration of recovery can vary based on individual healing rates and adherence to postoperative instructions.
| Short Descr | REVISION OF FOOT BONES | Medium Descr | ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR | Long Descr | Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure) | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
This is a primary code that can be used with these additional add-on codes.
| 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| 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. | 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) | T1 | Left foot, second digit | T6 | Right foot, second digit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.