Podiatry Coding & Billing Alert

Question: The podiatrist took an X-ray of a patient who tripped and fell down the stairs in his home. The X-ray showed a fracture in the patient's first metatarsal bone of his left foot. The podiatrist treated the fracture with a special orthotic boot. Which CPT^®  code should we report?

North Carolina Subscriber

Answer: You would report 28470 (Closed treatment of metatarsal fracture; without manipulation, each) for this procedure. In this case, the podiatristtreats the fracture without making a skin incision and without manipulating the fracture.

You'll notice that the code descriptor for 28470 includes the word "each," which refers to each metatarsal. For example, if the patient's left second and right fourth metatarsals are fractured, you could report 28470 twice - once for the closed treatment of the left second metatarsal fracture and second for the closed treatment of the right fourth metatarsal fracture. And don't forget to append the appropriate LT (Left side) and RT (Right side) modifiers.

Don't miss: You need to append TA (Left foot, great toe) to 28470.