CPT® Code 28600

Tarsometatarsal joint dislocation, commonly known as a Lisfranc dislocation, involves the dislocation of the joints between the tarsal bones and the metatarsal bones in the foot. This condition can lead to significant pain and dysfunction if not treated properly. The procedure described by CPT® Code 28600 refers to the closed treatment of this type of dislocation without the use of anesthesia. In this procedure, the healthcare provider first evaluates the neurovascular status of the foot to ensure that blood flow is adequate and that there are no signs of nerve damage. If a pulse is absent, an urgent reduction of the dislocated joint is performed without obtaining pre-reduction radiographs. However, if the neurovascular status is intact, the provider will obtain separate radiographs to assess the extent of the dislocation before proceeding with the closed reduction. The reduction technique involves applying longitudinal traction to the foot while simultaneously exerting pressure on the affected bones to realign them. After the reduction is successfully completed, the neurovascular status is re-evaluated, and a second set of radiographs is taken to confirm proper alignment. The toe is then immobilized using a splint, and the patient receives instructions to ice and elevate the foot to aid in recovery. It is important to use CPT® Code 28600 specifically when the dislocation is treated without anesthesia, while CPT® Code 28605 should be used when anesthesia is required for the procedure.