Podiatry Coding & Billing Alert

Question: Can you please explain the difference between 28288 and 28104? There has been some confusion in the office.

Ohio Subscriber

Answer: The codes you mention are as follows:

• 28288 (Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head)
• 28104 (Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus).

28288: With 28288, the podiatrist removes part of a single metatarsal head of the foot. The bone removal might involve » » the metatarsal head, which is called a condylectomy, or any associated bony growth, which is called an exostectomy.

Report 28288 for each metatarsal head the podiatrist performs this procedure on. And you should follow your payer's instructions to document multiple units by using modifiers like modifier 59 (Distinct procedural service) or modifiers TA (Left foot, great toe) through T9 (Right foot, fifth digit) to identify the left or right foot, and great toe through fifth digit, if appropriate.

28104: When the podiatrist performs a 28104 service, he removes a bone cyst or benign tumor from the tarsal or metatarsal region. Note: This code does not include the removal of a bone cyst or benign tumor from the talus or calcaneus, as indicated by the code's description.

Bottom line: With 28288, the podiatrist removes part of the metatarsal bone. On the other hand, with 28104, the podiatrist removes a bone cyst or benign tumor from the tarsal or metatarsal region, not including the talus or calcaneus.