Camille Posted Mon 25th of November, 2019 18:19:40 PM
Indication: Plantar fasciitis left foot. "...Attention was then directed to the left heel on the medial aspect where a 5 cm linear skin incision was made at the junction between the plantar and medial skin. This incision deepened with sharp and blunt dissection, carefully retracting the vital structures, bleeding vessels clamped and cauterized. The medial side of the plantar fascia was identified. The Freer elevator was then passed from medial to lateral at the dorsal junction. The 15 blade was then used to cut from dorsal to plantar, freeing the plantar fascia from the medial plantar and lateral aspect of the calcaneus..." The note goes on to describe flushing and closing the area. Does this describe CPT 28060 or 28008? Thank you, kindly!
SuperCoder Answered Tue 26th of November, 2019 06:10:13 AM
Thank you for your question
As per the above documentation, it seems that fasciotomy of the left foot for plantar fasciitis was performed, which qualifies it for CPT® code 28008.
In CPT® code 28008, when the patient is appropriately prepped and anesthetized, the provider makes a plantar incision exposing the deep fascia overlying the abductor hallucis and the medial plantar fascial band, a band of tissue that runs across the sole of the foot. He detaches the plantar fascia from the heel bone and or makes incisions on either side of the heel to release tension. He may rasp, or sand, the bony surface to reduce irritation to the fascia. The provider then irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
Note: In code 28060, the provider separates the plantar fascia from the heel bone, then removes and smooths the bone surface to heal the plantar fascia (which is not performed in your case, as per the above documentation). He removes the thin piece of the fascia from the abductor hallucis muscle to prevent the nerves from trapping, which can occur after the surgery. Finally, he closes the incision.
Hope that helps!
Camille Posted Tue 26th of November, 2019 13:41:43 PM
Thank you for great clarification!
SuperCoder Answered Wed 27th of November, 2019 00:47:45 AM
Thank you, happy to help.