Summary & Overview
CPT 28585: Open Treatment of Talotarsal Joint Dislocation
Headline: CPT code 28585 covers open surgical correction of talotarsal joint dislocation and is central to billing for midfoot and rearfoot reconstructive procedures. Lead: CPT code 28585 designates the open treatment of a talotarsal joint dislocation, with or without internal fixation, and applies to surgeries addressing abnormal separation between the talus and another tarsal bone.
CPT code 28585 represents a targeted orthopaedic surgical service for the midfoot and rearfoot. Nationally, accurate coding of this procedure affects hospital and ambulatory surgical center claims, resource allocation for orthopaedic services, and payment for operative foot and ankle care. The code is used when clinicians perform open reduction and possible fixation of dislocated talotarsal articulations.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure applies, expected sites of service, and common billing considerations tied to operative foot and ankle care. The publication provides benchmarks for utilization, summaries of relevant policy and coding guidance where available, and comparisons across major national payers. It also outlines common modifiers and administrative elements relevant to claim submission. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 28585 describes the open treatment of a talotarsal joint dislocation, an operative procedure to correct abnormal separation between the talus and an adjacent tarsal bone. The procedure may include internal fixation using implants such as pins or screws but can be performed without fixation depending on clinical circumstances.
Service Type: Surgical — Open operative orthopaedic procedure on the foot (midfoot/rearfoot).
Typical Site of Service: Inpatient or outpatient hospital operating room or ambulatory surgical center, depending on patient condition and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 34-year-old adult presents to the emergency department after an ankle inversion injury sustained during a fall from a ladder. The patient reports immediate severe midfoot and hindfoot pain, visible deformity, and inability to bear weight. Examination reveals malalignment of the talus relative to adjacent tarsal bones, ecchymosis, and focal tenderness over the talotarsal region. Plain radiographs demonstrate a talotarsal joint dislocation; CT is obtained for preoperative planning. The patient is consented for open treatment of talotarsal joint dislocation with possible internal fixation.
The clinical workflow includes: initial stabilization and neurovascular assessment in the ED; imaging (weight‑bearing radiographs if tolerated, otherwise non‑weight CT); preoperative optimization and consent; operating room procedure under regional or general anesthesia where the surgeon performs open reduction of the talotarsal joint and places implants (pins or screws) as needed; postoperative immobilization in a cast or boot; analgesia and DVT prophylaxis as indicated; and arranged follow‑up for wound checks, radiographic healing assessment, and progressive weight‑bearing rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | When the procedure is performed on the right foot |