CPT® Code 28545

The procedure described by CPT® Code 28545 refers to the closed treatment of a dislocation involving the tarsal bones, excluding the talotarsal joint, and necessitating the use of anesthesia. The tarsal bones consist of seven individual bones, including the talus, which is not included in this specific code. The remaining six tarsal bones are the calcaneus, cuboid, navicular, and three cuneiform bones (medial, intermediate, and lateral). Dislocations of these tarsal bones are considered rare injuries, and their management requires careful evaluation of the neurovascular status of the foot. In cases where a pulse is absent, an urgent reduction of the affected mid-foot joint is performed without the need for pre-reduction radiographs. Conversely, if the neurovascular status is intact, separate radiographs are obtained to assess the injury further. The reduction process involves applying longitudinal traction to the foot while simultaneously exerting pressure on the dislocated bones. After the dislocation is successfully reduced, the neurovascular status is re-evaluated, and a second set of radiographs is taken to confirm the proper alignment of the bones. Following the procedure, the foot is immobilized in a splint, and the patient is advised to apply ice and elevate the foot to aid in recovery. It is important to note that CPT® Code 28540 should be used when the dislocation is treated without anesthesia, while CPT® Code 28545 is specifically designated for cases requiring anesthesia.