In 2018 the definition for Category III code 0335T read “extra-osseousâ€ subtalar joint implant for talotarsal stabilization. With many of the implants that we use for fracture treatment the screws are placed within the bone (intra-osseous) whereas an extra-osseous implant is placed outside of the bone and when used in the application of talotarsal stabilization the implant is placed into the sinus tarsi.
In 2019 the AMA determined that they would modify code 0335T to read – Insertion of sinus tarsi implant because this code description better identifies the area into which the implant is being placed. This type of implant is used to correct flat-foot conditions. What happens is the talus will slide forward and downward taking this bone out of its normal axis and placing all of the weight in the area of the arch causing it to collapse. To correct this condition the physician will manipulate the talus back into its anatomical location, and I use the term “manipulateâ€ loosely because this is not a dislocation treatment. Once the talus is in the proper position, a thick screw type device will be placed in the sinus tarsi to hold the talus in place. As previously stated, this is neither a dislocation nor arthrodesis treatment.
Besides the revised code description for 0335T, the AMA also developed two new Category III codes which are 0510T Removal of sinus tarsi implant and 0511T Removal and reinsertion of sinus tarsi implant. Additionally, the are parenthetical notes under CPT code 20680 directing you to the Category III codes 0510T-0511T when the device is a sinus tarsi implant.