# Lapidus Bunionectomy



## KimberlyViruet (Dec 27, 2012)

Podiatry question -

Can anyone tell me how you would code a Lapidus-type bunionectomy with an Akin osteotomy?

I know the CPT code for the Lapidus procedure is 28297 and the Akin procedure is 28298, but you cannot use both. 

Can you use 28297 and 28310 with modifier 59?

Thanks so much!


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## nsteinhauser (Dec 28, 2012)

I don't know if there are any more RECENT documents to uphold/dispute what is stated below but this is information from the Amer. Academy of Orthopaedic Surgeons - or AAOS.  According to this, you can code separately for osteotomy of the  first proximal phalanx........

August 2002 Bulletin
Bunionectomy codes

Selecting the right ones for a toe/foot procedure is key

By Margie Scalley Vaught, CPC, CCS-P, MCS-P and reviewed by Walter J. Pedowitz, MD

28297 - ; Lapidus type procedure This procedure is a distal soft tissue rearrangement and a proximal first metatarsal cunieform arthrodesis. AAOS states that this procedure includes: arthrotomy, tendon transfer or release, synovectomy, capsular release and/or reconstruction, removal of additional exostoses in the area of the joint, internal fixation, removal of bursal tissue, repair of released tendon, arthrodesis, tarsometatarsal joint, local bone graft, proximal first metatarsal osteotomy and allows additional coding and report for: phalangeal osteotomy to correct deformity, harvesting and insertion of bone graft from distant site (separate skin or fascial incision) and ankle tendon lengthening.


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