Podiatry Coding & Billing Alert

Question: Can you explain the difference between CPT^® codes 28055 and 28080?

AAPC Forum Participant

Answer: These codes can be confusing as they fall within the “repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon” range of the CPT^® code set. In 28055 (Neurectomy, intrinsic musculature of foot), the provider removes any inflamed bursal tissue and dissects the nerve, dividing it at the upper point to relieve pain. For example, the provider makes an incision in the dorsal skin between the intermetatarsal spaces from the metatarsal head through the end of the web space’s skin fold. The provider divides the transverse metatarsal ligament, spreads the metatarsal heads, and dissects and divides the nerve at the upper point. Finally, he irrigates the wound with antibiotic solution and closes the wound in layers.

In contrast, 28080 (Excision, interdigital [Morton] neuroma, single, each) describes a procedure in which the provider removes a Morton’s neuroma, which is a painful condition that causes thickening of the plantar nerve between the metatarsal heads. The main difference between the two codes is location. With 28055, the practitioner is working on the plantar nerves, not the metatarsal heads.

And don’t forget to add the correct diagnosis code from G57.6- (Lesion of plantar nerve) to indicate medical necessity for the 28080, as Morton’s metatarsalgia is a synonym for G57.6. You’ll also need to add the appropriate 5th character from 1 (… right lower limb), 2 (… left lower limb), or 3 (… bilateral lower limb) to indicate laterality.