# ORIF Tarsometatarsal FX



## orthopaedic01 (Apr 6, 2009)

Doc did ORIF of 1st, 2nd, 3rd and 4th tarsometatarsal fracture (Lisfranc). Would you choose 28485? If so would you charge it once and then 3 X with modifier 59? 
Thanks!


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## Lanie Christman (Apr 6, 2009)

28485 is the correct code--If the patient is MCR..then you will bill RT/LT with modifier 59...but if commercial insurance you will use the modifiers TA-T2 or T5-T7 not modifier 59.
Ex:  28485 TA
      28485 T1/51
      28485 T2/51

28485 LT
28485 59/LT
28485 59/LT
*I would put in procedure comments stating the specific MTL if MCR

Hope this helps!
Lanie


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## martnel (Apr 6, 2009)

I thought you could only use the T-modifiers on the phalanges and not on TMT's?


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## Lanie Christman (Apr 7, 2009)

I actually didn't know that--but I did just read a publication, you are correct. I'm sorry...the publication states to use LT or RT.  So I would code by line item and use the modifier 59.

_The proper use of modifiers is very important. Start with the T modifiers to identify a surgery performed on specific toes. T modifiers only apply to the phalanges distal to the metatarsophalangeal joint. Do not use T codes to identify metatarsal work. For metatarsal and more proximal work, one should also use RT and LT modifiers whenever possible. If those two are not appropriate, use the -59 modifier_.


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## aprilroc (Apr 7, 2009)

ORIF Tarsometatarsal joint dislocation is 28615 and can be charged for each.


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## orthopaedic01 (Apr 8, 2009)

28615 is for dislocation, not fracture though.


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