Podiatry Coding & Billing Alert

Question: What code should I report when the podiatrist performs a partial excision of the talus bone?

New York Subscriber

Answer: When the podiatrist removes the infected portion of the talus or calcaneus bone using craterization, saucerization, or diaphysectomy, you would report 28120 (Partial excision [craterization, saucerization, sequestrectomy, or diaphysectomy] bone [eg, osteomyelitis or bossing); talus or calcaneus]).

In this procedure, the podiatrist makes an incision on the patient's posterior aspect of the foot. He dissects the soft tissues, bursa, and tendons from the insertion point of the Achilles tendon.

The podiatrist then separates the Achilles tendon from its attachments and identifies the infected bone. Once he identifies the infected bone, he will partially excise the infected portion. He will either excise the bone in a crater-like piece, leaving a small, saucer-like depression in the bone, or he will excise the portion of the shaft of the long bone.

The podiatrist may fill the cavity left in the bone using a bone graft. Or, he may use sutures to reattach the Achilles tendon to the remaining calcaneus. Finally, he will close the wound in layers.

Caution: Don't mix up 28120 with 28122 (Partial excision [craterization, saucerization, sequestrectomy, or diaphysectomy] bone [eg, osteomyelitis or bossing]; tarsal or metatarsal bone, except talus or calcaneus). Although the two codes are similar, 28122 specifies "except talus or calcaneus."