Podiatry Coding & Billing Alert
Decipher Mallet Toe Correction Scenario
Question: I am coding a mallet toe correction. The CPT® code I am using is 28285 (Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy))-TA (Left foot, great toe). The diagnosis code I have is M20.5X2 (Other deformities of toe(s) (acquired), left foot). My billing office sent the claim back to me, saying that 28285 is failing medical necessity. I don’t see another CPT® code that sounds correct, so is it a problem with my ICD-10-CM code? Can mallet toe be coded as hammertoe? AAPC Forum Participant Answer: Code 28285 is the correct CPT® code for mallet toe correction, as well as claw toe or hammertoe deformity. The reason for the rejection is the ICD-10-CM code you used. M20.42 (Other hammer toe(s) (acquired), left foot) would be the more correct code to report.
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Decipher Mallet Toe Correction Scenario
Question: I am coding a mallet toe correction. The CPT® code I am using is 28285 [...]
