# terminal syme amputation



## Jamie Dezenzo (Jan 30, 2012)

Hello all,

terminal syme amputation of the distal portion of the hallux

since the amputation was not at the joint, just 11752 or more like 28124?

Thanks!
Jamie


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## AGNewman (Feb 15, 2013)

Hi Jamie
I am working on the exact same type of surgery!

11752 The nail matrixectomy w/tuft is soft tissue only and no bone involved. 
28124 Partial excision of the phalanx would leave some in place; also not appropriate.
28825 is full or partial removal of the toe at the IPJ so this would be the appropriate code.

"A terminal Syme amputation of part of the last bone of the toe (distal phalanx) is done via an elliptical incision and involves resection of the toenail, nail bed, and approximately half of the distal phalanx, usually of the great toe. After the initial skin incision, the flexor and extensor tendons on the part of the distal phalanx closest to the body (proximal distal phalanx) are left intact if possible. Nerves and vessels are clamped off or tied, and the bone is shortened and contoured smoothly part-way along the distal phalanx. The nail bed including the toenail is removed. The wound is closed by placing the skin flap over the stump and suturing the skin."


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## Kelly_Josephine (Dec 17, 2015)

*late follow up on terminal some amputation*

I often find these old threads very helpful for my current questions, as I am sure others do... As an FYI to others, The instructions under 28825 direct "(For amputation of tuft of distal phalanx, use 11752.) 

11752 currently reads: Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal; with amputation of tuft of distal phalanx .


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