Podiatry Coding & Billing Alert

Question: Can you bill bunionectomy codes 28297 with 28299 or 28292?

Iowa Subscriber

Answer: The codes you mention are as follows:

• 28292, Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with resection of proximal phalanx base, when performed, any method
• 28297, ... with first metatarsal and medial cuneiform joint arthrodesis, any method
• 28299, ... with double osteotomy, any method.

Remember to check the Correct Coding Initiative (CCI) edits when billing codes together. According to the CCI edits, 28299 is a column 2 code for 28297, so you would not normally bill the two together. However, a modifier indicator of 1 allows you to override this edit when appropriate.

Also, according to the CCI edits, 28292 is a column 2 code for 28297, so you would not normally bill these two codes together. However, once again, a modifier indicator of 1 allows you to override the edit when appropriate.

Caution:  The medical documentation and clinical circumstances must always support your decision to use a modifier. Examples include separate sites or sessions for the services. Never append a modifier just to bypass the edit.