# Condylectomy of proximal phalanx 2nd toe



## Lliza71 (May 29, 2009)

HELP ME PLEASE, SOMEONE!!!!

My doc did a condylectomy of pt's 2nd toe; proximal phalanx. The op report states _"...The distal aspect of the proximal phalanx condyle was directly exposed and a condylectomy perfored using a bone cutting rongeur."_

I have been all over the CPT book, looking for the last hour w/our head coder here, and we can't find a code!  The closest we come is 28288 (which is what the dr used) but that's for the metatarsal head. Not the prox phalanx. Then there's 28153, but that's for the DISTAL phalanx...not proximal.

Can anyone help???
I'm becoming a little frazzled!!  

Liza Baccari, CPC
NJ


----------



## Bella Cullen (May 29, 2009)

I would use 28153 because in the coders desk reference the description says: The physician resects the condyle of the distal end of the phalanx, amputating the toe. The physician makes a curvilinear incision to fashion "fish-mouth" skin flaps side-to -side or dorsally to plantarly. The amputation can be done as a disarticulation or by resecting through the bone. *If* the head of the toe is disarticulated, the capsular ligaments are severed and *the distal phalanx is removed*. The capsule is approximated with sutures. *If the bone is resected, a power saw is used to transect the proximal phalanx.* A drain may be used. The skin flaps are approximated with sutures and a compression dressing is applied. 

I would use 28153.


----------



## mbort (May 29, 2009)

28126--phalangeal base would be the proximal end

Mary, CPC, COSC


----------



## Lliza71 (May 29, 2009)

*prox phalanx*

Oh...u are so right!  
the op note does say...the distal aspect of the prox phalanx.
I guess I needed someone to point out the obvious. It just wouldn't make sense to me. Thanx so much!
Now I can't get ready to get outta here!!
Liza


----------

