# Drilling/Microfracture of Metatarsal for AVN - open procedure



## caromissunc1 (Dec 17, 2012)

Greetings All,
My doc did an open procedure and performed microfracture technique on the head of a metatarsal for treatment of metatarsal AVN using a drill and a .35 K-Wire.
I cannot find a good CPT code for this. Any assistance would be greatly appreciated.
Happy Holidays!


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## lchilliard (Sep 8, 2016)

*Still the same question*

well it has almost been 4 years since someone asked about microfracture technique on a first metatarsal- no one really responded in the past- any new information.? I cannot find a cpt code that addresses this. Normally it would be included in a larger procedure- but this was the only thing done. No one likes using the unlisted procedure code 28899. Does anyone have any information on a cpt code that would address the microfracture technique and drilling of the first metatarsal?

Thanks-


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## AlanPechacek (Sep 13, 2016)

His treatment of AVN of the Metatarsal Head was not technically a "Microfracture" procedure, but a "Multiple Drilling" procedure to try to restore circulation (revascularize) to the "dead bone," and hopefully get it to "heal" back to normal bone.  It is fundamentally the same as Core Decompression of the Femoral Head for AVN (without grafting) (which I can't find a CPT Code for), and the Multiple Drilling done in the knee for Osteochondritis Dissecans, alone for a stable lesion (29886), or with grafting and/or fixation for loose or unstable lesions (29885, 29887).  There is no Code for this procedure for the Metatarsal Head, and you would need to use an Unlisted code for the foot, and it probably pairs best with 29886.

I hope this helps some.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com


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