# hallux limitus



## Peggy M (May 6, 2009)

I have a podiatrist that did a MPJ replacement for hallux limitus.  He found an article in a podiatry magazine that states that you can use 28293 for hallux limitus.  I don't agree because the patient does not have a bunion.  Don't you have to have a bunion to use 28293 (that is what the CPT description says)?  I suggested the unlisted code.  
Does any one have any suggestions?  Am I wrong and you can use 28293 or do we have to use the unlisted code?
Thanks
Peggy


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## sphillips79 (May 6, 2009)

I use 28293 for the mcj joint replacement when a double implant is used for my podiatrist's, I try to stay away from unlisted codes as much as possible.


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## Bella Cullen (May 6, 2009)

I agree with Steffie.


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## Peggy M (May 6, 2009)

So, even though the patient doesn't have a bunion you use a bunion correction code?  
thanks
Peggy


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## Bella Cullen (May 7, 2009)

Peggy M said:


> So, even though the patient doesn't have a bunion you use a bunion correction code?
> thanks
> Peggy



In the CPT book it says Hallux Valgus Correction, resection of joint with implant. The definition of Hallux Valgus is:

Definitions:
1. a deviation of the disal portion of the great toe, at the metatarsophalangeal joint, toward the outer or lateral side of the foot.

The definition of a bunion is:

Definitions:
1. A localized swelling at either the medial or dorsal aspect of the first metatarsophalangeal joint, caused by an inflammatory bursa; a medial bunion is usually associated with hallux valgus. 

So Hallux valgus does not mean a bunion, it is just usually associated with bunions.

So I think 28293 would be the correct code for your case.


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## Peggy M (May 11, 2009)

I totally appreciate your help on this.  I have one more question.  The patient doesn't have hallux valgus or any problem with the alignment of the toe.  The patient has hallux limitus (degeneration of the joint) which is just stiffening of the joint.  He put the joint in there to help the patient have more motion with the big toe.
Why is there no arthoplasty for the toes?  That is what this is.  I know I have some info from an audio-conference that margie vaught put on and she said at that time that we should be using the unlisted code.  This info was from 2006 so I am not sure if this is still correct.
thanks
Peggy


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