Podiatry Coding & Billing Alert

Question: The podiatrist repaired a great toe fracture without surgery or manipulation. What CPT^® code should I report?

Nebraska Subscriber

Answer: To report the podiatrist repairing a great toe or phalanx fracture without surgery or manipulation, look to 28490 (Closed treatment of fracture great toe, phalanx or phalanges; without manipulation).

Note: In this case, the podiatrist does not break the skin to treat the fracture. He also does not manipulate the fracture, realign the ends of the fractured bone to its original position, to repair it.

When he provides a 28490 service, the podiatrist confirms the fracture by X-ray, then he tapes the broken toe to an adjacent toe to hold it into place to promote healing. He will put gauze between the patient’s toes to absorb moisture. The podiatrist then instructs the patient to replace the tape and gauze as needed. He will tell the patient to elevate the injury and to limit weight-bearing activity on the affected foot.

Diabetic patients: If the patient is diabetic, the podiatrist will not tape her toes together. Instead, he will fit her with a rigid flat-soled shoe to wear for up to three weeks. In other cases, the podiatrist may fit the patient with a fracture brace or walking cast with a toe plate. The patient may also need to use crutches for walking.