28264 ??? Help


Virginia Beach, VA
Best answers
I would like some opinions on this surgery. I was thinking CPT 28264 was the closest, but I wasnt sure and wanted to see if I could get more opions.
Thank you

Right chronic lateral midfoot instability.

Debridement repair of right lateral midfoot ligament instability.


We began by making approximately 4 to 5 cm longitudinal incision over the lateral
aspect of the right foot around the area of the fourth and fifth metatarsal
cuboid articulation. The incision was carried down by blunt and sharp
dissection with care protecting surrounding neurovascular structures. We
identified the fourth and fifth metatarsal cuboid joint and there was large
scarring overlying the ligaments of fourth and fifth metatarsal cuboid joint.
We simulated stress and had ligamentous instability to lateral midfoot. We
opened the dorsum of the fourth metatarsal cuboid joint in a transverse
fashion. We evaluated this fourth and fifth metatarsal cuboid joint. On the
dorsum part of the fourth and fifth joint, there was some thinning of the
cartilage, but no impaction injury. No overt acute loose body present. We
prepared for imbrication by creating a small trough of bone on both sides of
the joint. We then imbricated the ligaments with interrupted nonabsorbable
suture. Once we completed this, we did not appreciate any further pathology.
We then stabilize the joints with two 0.062 K-wires passed across the fourth
and fifth metatarsal cuboid joint which we did initially under direct
visualization and verified under fluoroscopy. We were satisfied with the
position of these K-wires and we placed protective caps over this and then
placed sterile dressings over this and protective dressings and fashioned a
well padded posterior knee tied for this patient.