Plantar plate repair

Good evening

Recently repaired PL tendon with moderate resection of diseased/torn tendon with retubularization. Also placed a collagen implant-not considered a graft but an implant-Regeneten-Smith and Nephew.-------28210?

Bone spur removal-28118

is there also a code for debridement of the tendon-extensive debridement.

Look forward to your comments.

Enzo Leone

Procedure is secondary repair of plantar plate without graft 2nd MTP joint.

Thank you for the input.

This is a great question, it all depends on how you describe what you are addressing surgically.

Let’s do a deep dive into the anatomy of what you are repairing. You did not state what you are doing in your “plantar plate repair” I have always suggested to providers to use the CPT language that matches the surgery you are doing.

 Typically, the flexor tendon expands plantarly and becomes the plantar plate. So, isn’t this really a flexor tear. You need to decide what type of repair you are doing, is it primary or secondary and then are you using a tendon graft or not? Or is this just a soft tissue toe repair? You asked about The CPT 28313, it is defined as "Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)". If you are working on a toe only and not the flexor tendon tear plantarly, then sure consider using CPT 28313.

There are 2 specific CPT codes to consider for the flexor tear issue:

1)Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon=CPT 28200 OR

2) Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft) CPT 28002.

The bottom line describe exactly what you are doing anatomically, then you can pick the right CPT code to match the procedure.