Outpatient Facility Coding Alert

You Be the Coder:

Beware of Difference Between Bone Excision and Osteotomy

Question: The orthopedist completed an extra ray excision and osteotomy of the patient’s left foot first metatarsal. He made an incision down through subcutaneous tissue and dissected to the bone. The mass was bigger than what was suggested by the bony aspect of it on X-ray. Further examination showed the tumor was connecting in the side of the metatarsal itself rather than in the joint. Therefore, he performed an osteotomy to remove it. The final diagnosis was left foot first metatarsal extra ray polydactyly. How do we report the surgery?

Pennsylvania Subscriber

Answer: This is only an excision of bone and not really an osteotomy per se, because the surgeon only performed the osteotomy to excise the bone and the tumor. You should report 28344 (Reconstruction, toe[s]; polydactyly) for this procedure.


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