Orthopedic Coding Alert

Reader Questions:

Avoid 26535 for the Toe

Question: Is code 26535 limited strictly to the hand, or can we use it for an interphalangeal arthroplasty of the toe?

Florida Subscriber

Answer: No, it would not be appropriate to report 26535 (Arthroplasty, interphalangeal joint; each joint) for an IP joint arthroplasty of the toe. Because no CPT code specifically describes the procedure that your physician performed, you should instead report 28899 (Unlisted procedure, foot or toes).
 
- You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at UMDNJ-RWJ University Orthopaedic Group in New Brunswick, N.J.

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