CPT® Code 28605

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 28605 refers to the closed treatment of this type of dislocation, which necessitates the use of anesthesia. Prior to the treatment, the neurovascular status of the foot is assessed to ensure that blood flow is adequate. If a pulse is absent, an urgent reduction of the dislocated joint is performed without the need for pre-reduction radiographs. However, if the neurovascular status is intact, radiographs are obtained to evaluate the extent of the dislocation. The closed reduction technique involves applying longitudinal traction to the foot while simultaneously exerting pressure on the affected bones to realign them. After the reduction is completed, the neurovascular status is re-evaluated, and a second set of radiographs is taken to confirm proper alignment. The final step in the procedure involves immobilizing the toe in a splint, and the patient is advised to ice and elevate the foot to aid in recovery. It is important to note that CPT® Code 28605 is specifically used when anesthesia is required for the procedure, whereas CPT® Code 28600 is applicable when the dislocation is treated without anesthesia.