Advanced Search

Podiatry Coding & Billing Alert

Reader Question:

28485 Keeps This Reduction Claim From Getting Crushed

Published on Fri Jul 22, 2011

Question: I recently performed an open reduction on the first metatarsal head of a patient who has avascular necrosis and smashed her foot against a table, crushing a good portion of the bone. In addition to the open reduction, I needed to use bone paste to reconstruct the metatarsal head and fill in voids, and then applied an external fixation device. How should I code this procedure?Idaho SubscriberAnswer: Most likely, you will just be able to code 28485 (Open treatment of metatarsal fracture, includes internal fixation, when performed, each) for the entire scenario that you present. Reason: Most carriers will include any reconstruction and use of bone paste as an inherent part of the open reduction.Other possibility: If you think that the metatarsal head reconstruction involved work considerably greater than that  described in 28485, you may consider appending modifier 22 (Unusual procedural services).Remember that most payers review modifier 22 claims [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Podiatry Coding & Billing Alert

View All