Choose Between 28296 and 28306 for Crescentic Osteotomy
Question: How should I code a crescent shelf osteotomy for a hallux valgus case?
New York Subscriber
Answer: You have two coding options to choose from when reporting this service.
One option is to use 28296 (Correction, hallux valgus [bunion], with or without sesamoidectomy; with metatarsal osteotomy [e.g., Mitchell, Chevron, or concentric type procedures]).
The second option is to select 28306 (Osteotomy, with or without lengthening, shortening, or angular correction, metatarsal; first metatarsal).
In a crescentic osteotomy procedure, the proximal portion of the first metatarsal is the subject of the osteotomy. The descriptor for 28306 more closely matches the procedure for a crescentic osteotomy. The procedure requires fixation, and the patient must keep weight off the foot for several weeks.
Explanation: According to the Coders Desk Reference, code 28306 represents a procedure in which “weight bearing is protected for several weeks” — similar to a crescentic osteotomy. No mention of this weight-bearing protection is made for 28296. So 28306 would really be the more appropriate code choice.
