2025 CPT code 28505
(Active) Effective Date: N/A Surgery - Fracture and/or Dislocation Procedures on the Foot and Toes Musculoskeletal System Feed
Open treatment of a fracture of the great toe phalanx or phalanges, including internal fixation when performed.
Modifiers may be applicable in certain circumstances (e.g., -54 Surgical Care Only, -76 Repeat Procedure by Same Physician).
Medical necessity must be established by documenting the severity of the fracture, failure of conservative treatment, or the presence of complications that require surgical intervention.
The physician is responsible for the complete surgical procedure, including pre-operative planning, obtaining informed consent, performing the surgery, post-operative care, and managing any complications.
In simple words: This procedure fixes a broken big toe by surgery. The doctor makes a cut to see the broken bone, puts the pieces back together, and may use metal pins or screws to hold them in place.Then, the cut is closed up with stitches.
This code describes a surgical procedure involving open treatment of a fracture in the phalanx or phalanges of the great toe.The procedure may include the use of internal fixation devices such as pins, screws, wires, plates, or rods to stabilize the fractured bones. The procedure involves making an incision to access the fracture site, reducing the fracture (realigning the bone fragments), and then applying internal fixation if necessary.The skin and other tissues are then closed with sutures or staples.
Example 1: A patient sustains a comminuted fracture of the distal phalanx of the great toe in a crush injury. Open reduction and internal fixation with screws are required to stabilize the fracture., A patient presents with a displaced fracture of the proximal phalanx of the great toe following a fall.Open reduction and internal fixation with K-wires are performed., A patient has a non-union of a previously treated great toe fracture.Open treatment with bone grafting and internal fixation with a plate is necessary to promote healing.
Documentation should include details of the injury, physical exam findings, type of fracture, method of reduction, type of internal fixation used (if any), any complications encountered, and post-operative instructions.
** Application and removal of the initial cast, splint, or traction device is included in the procedure. Replacement of these devices during the global period can be billed separately.
- Global Days : 90 days
- Payment Status: Active
- Modifier TC rule: No information on a specific TC modifier rule in the provided information
- Specialties:Orthopedic Surgery, Podiatry
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Physician's Office