2025 CPT code 28490
(Active) Effective Date: N/A Surgery - Fracture and/or Dislocation Procedures on the Foot and Toes Musculoskeletal System Feed
Closed treatment of fracture great toe, phalanx or phalanges; without manipulation.
Modifiers may be applicable in certain situations. For example, modifier 54 is used if the provider performing the initial treatment will not be providing subsequent care. Other modifiers may also be applicable, always refer to updated modifier guidelines.
Medical necessity for 28490 is established by the presence of a fracture of the great toe, phalanx, or phalanges requiring immobilization for healing.The chosen method of treatment must be appropriate for the specific fracture and patient condition.
The physician is responsible for evaluating the fracture, choosing the appropriate method of immobilization (taping, splinting, surgical shoe, etc.), providing patient education on care and weight-bearing restrictions, and managing the healing process.
In simple words: This procedure involves treating a broken great toe (or other toe bones) without surgery or moving the broken bone pieces back into place.The doctor may tape the toe, put it in a splint, or have you wear a special shoe to help it heal.
This code represents the closed treatment of a fracture of the great toe, phalanx, or phalanges without manipulation.Closed treatment signifies that the fracture site is not surgically opened.The absence of manipulation indicates that the bone fragments are not realigned or reduced. This typically involves stabilizing the toe with methods like taping, splinting, or using a surgical shoe.
Example 1: A patient presents with a non-displaced fracture of the distal phalanx of the great toe. The physician chooses to buddy tape the toe to the adjacent toe for stabilization., A patient with diabetes has a minimally displaced fracture of the proximal phalanx of the second toe.Due to concerns about circulation, the physician decides against buddy taping and instead places the patient in a surgical shoe., A patient sustains multiple fractures of the phalanges of the great toe in a crush injury. The physician applies a splint to immobilize the toe and instructs the patient on elevation and limited weight-bearing.
Documentation should include details of the fracture (location, displacement), method of treatment (buddy taping, splinting, etc.), instructions given to the patient (weight-bearing status, follow-up care), and any associated injuries. Radiographic evidence of the fracture is also required.
** For multiple fractures of the same toe treated with the same method, this code is typically reported only once.
- Revenue Code: P6B - MINOR PROCEDURES - MUSCULOSKELETAL
- Global Days : 90 days
- Payment Status: Active
- Modifier TC rule: No information available.
- Fee Schedule : No information on historical fee schedule is available in provided sources. Refer to CMS or other fee schedule resources for historical data.
- Specialties:Orthopedic Surgery, Podiatry, Emergency Medicine, Family Medicine
- Place of Service:Office, Inpatient Hospital, On Campus-Outpatient Hospital, Emergency Room - Hospital,Outpatient Hospital, Ambulatory Surgical Center,Independent Clinic,Federally Qualified Health Center, Rural Health Clinic.