# Removal of bone fragment from foot



## tlm5506 (Oct 23, 2014)

Hello.
Looking for help with a code for this procedure. Fragment was identified as bone:

An incision was made laterally at the calcaneal cuboid joint through skin and subcutaneous tissue. The fragment was identified. The peroneal tendon did have attachment to the fragment. It was debrided soft tissue attachment and removed. It was sent as a specimen.

I've been looking for hours and can't come up with anything.
Any help would be appreciated.
Thanks.


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## PLAIDMAN (Oct 30, 2014)

tlm5506 said:


> Hello.
> Looking for help with a code for this procedure. Fragment was identified as bone:
> 
> An incision was made laterally at the calcaneal cuboid joint through skin and subcutaneous tissue. The fragment was identified. The peroneal tendon did have attachment to the fragment. It was debrided soft tissue attachment and removed. It was sent as a specimen.
> ...



I would use a loose or foreign body excision code


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## KimberlySherman (May 21, 2020)

The fragment of bone represents an avulsion fracture of a tarsal bone, either the calcaneus or the cuboid. The ICD-10 index shows that bone avulsions are coded as fractures. The removal of the bone fragment via an incision represents open treatment of the fracture. This is coded with 28415 for the calcaneus, or 28465 for the cuboid. The two peroneal tendons in this are are the peroneal brevis and longus. The peroneal brevis attaches to the base of the 5th metatarsal, so that is unlikely to be the site of the fracture, since the fragment is in  the area of the calcaneal-cuboid joint. The peroneal longus attaches to a groove in the cuboid. Since the bone fragment was attached to the peroneal tendon, the peroneal longus tendon must have avulsed off of the cuboid, taking a piece of bone with it. The correct code is 28456, _Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each_.


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