Podiatry Coding & Billing Alert

Question: Is there such a thing as an “anterior tarsal tunnel release?” My podiatrist wants to perform this procedure on a patient, and all we can find in the CPT^® manual is posterior.

California Subscriber

Answer: If the podiatrist performs a posterior tarsal tunnel release, you could look to code 28035 (Release, tarsal tunnel (posterior tibial nerve decompression)).

During a 28035 procedure, the podiatrist makes a skin incision midway between the patient’s Achilles tendon and the back of the medial malleolus. He incises the retinaculum, identifies the posterior tibial nerve, and separates it from the artery and vein in the tarsal tunnel.

He places vessel loops around the vessels and gently retract them, further releasing the nerve. If there is any scarring in the posterior tibial nerve or its branches, he opens the outer layer of the nerve wrapping and removes the scar tissue from within the nerve. The provider then irrigates the area, checks for bleeding, removes any instruments, and closes the incision.