08/28/2017
CPT Codes for Repairing a Ruptured Plantar Fascia
I am planning to surgically repair the rupture of the plantar fascia and cannot find an appropriate code. Help
There are four CPT codes that could be used for the repair of a ruptured plantar fascia. One of the following codes may be used depending on the patient’s clinical condition:
28008
Code Description:
Fasciotomy, foot and/or toe
Lay Description (Code):
There are two common techniques used in fasciotomies of the foot and/or toes. For flexion contracture of the toe, a plantar incision is made. A transverse division of the fibrotic and contracted cord of plantar fascia in the foot and/or toe is performed through one or more incisions. A percutaneous procedure may be performed instead which involves making a stab incision over the center of the plantar fascia where it attaches to the calcaneus. The plantar fascia is transversely divided.
Coding Tips
According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. See "Application of Casts and Strapping" in the CPT book in the Surgery section, under Musculoskeletal System. For a plantar fasciectomy, see 28060 and 28062. For division of the plantar fascia (Steindler stripping), see 28250. For an endoscopic plantar fasciotomy, see 29893.
28060
Code Description:
Fasciectomy, plantar fascia; partial (separate procedure)
Lay Description (Code):
Heel pain originates deep within the foot, directly on the heel bone or within the foot's connective tissues, called the fascia. Pain can result when these tissues become irritated or inflamed, or when small spurs grow on the heel bone. Prior to surgery a tourniquet is applied to the ankle. The surgeon makes a longitudinal incision inside the heel and the fat that has filled the wound is separated with a key elevator. The medial third of the plantar fascia is identified using right angle retractors under direct vision. Report 28062 when the medial third of the plantar fascia is incised and a 1-centimeter segment is removed. The tourniquet is released and the skin closed with nonabsorbable sutures. A dressing and a removable walking boot are applied. The sutures are removed in about three weeks and weightbearing is increased; though the radical procedure increases postoperative recovery period.
Coding Tips
These separate procedures by definition are usually a component of a more complex service and are not identified separately. When performed alone or with other unrelated procedures/services they may be reported. If performed alone, list the code; if performed with other unrelated procedures/services, list the code and append 59 or an X{EPSU} modifier. According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. See "Application of Casts and Strapping" in the CPT book in the Surgery section, under Musculoskeletal System. For plantar fasciotomy, see 28008. For division of plantar fascia and muscle, see 28250.
28062
Code Description:
Fasciectomy, plantar fascia; radical (separate procedure)
Lay Description (Code):
Heel pain originates deep within the foot, directly on the heel bone or within the foot's connective tissues, called the fascia. Pain can result when these tissues become irritated or inflamed, or when small spurs grow on the heel bone. Prior to surgery a tourniquet is applied to the ankle. The surgeon makes a longitudinal incision inside the heel and the fat that has filled the wound is separated with a key elevator. The medial third of the plantar fascia is identified using right angle retractors under direct vision. Report 28062 when the medial third of the plantar fascia is incised and a 1-centimeter segment is removed. The tourniquet is released and the skin closed with nonabsorbable sutures. A dressing and a removable walking boot are applied. The sutures are removed in about three weeks and weightbearing is increased; though the radical procedure increases postoperative recovery period
Coding Tips
These separate procedures by definition are usually a component of a more complex service and are not identified separately. When performed alone or with other unrelated procedures/services they may be reported. If performed alone, list the code; if performed with other unrelated procedures/services, list the code and append 59 or an X{EPSU} modifier. According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. See "Application of Casts and Strapping" in the CPT book in the Surgery section, under Musculoskeletal System. For plantar fasciotomy, see 28008. For division of plantar fascia and muscle, see 28250.
28250
Code Description:
Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure).
Lay Description (Code):
A longitudinal incision is made on the medial side of the heel and is carried distally to the other side of the heel in order to expose the underlying soft tissues. The superficial and deep layers of the plantar fascia are separated from the muscle and fat by blunt dissection. This allows for freedom of movement of the fascia and releases the scar tissue. Once sufficient movement is obtained, the incision is sutured and a soft dressing is applied. Weight bearing is allowed as the wound heals
Coding Tips
This separate procedure by definition is usually a component of a more complex service and is not identified separately. When performed alone or with other unrelated procedures/services it may be reported. If performed alone, list the code; if performed with other procedures/services, list the code and append 59 or an X{EPSU} modifier. For fasciotomy of foot or toe, see 28008. For plantar fasciectomy, see 28060-28062.