Podiatry Coding & Billing Alert

Question: Below is an example of a typical note I have to code for amputation:

Toes were examined, and patient had some viability at the very base of the toes at the sulcus area therefore, it was elected instead of doing a transmetatarsal amputation to perform digital amputations 1-5, which are disarticulations. It should also be noted that the second, third, and fifth metatarsal heads were resected to make a more even parabola so that there would not be any tension on the wound during closure.

How should I code this? If I code 28820, I am completely leaving out the resection of the metatarsal bone. If I code 28810, this includes the entire metatarsal, not just the head.

AAPC Forum Participant

Answer: Code 28820 (Amputation, toe; metatarsophalangeal joint) would be the most appropriate in this case because the surgical procedure involves amputation of the toes at the metatarsophalangeal joints. This joint is the connection between the metatarsal bones of the foot and the proximal phalanges of the toes. If the toe and metatarsal were amputated, then you would choose code 28810 (Amputation, metatarsal, with toe, single). Code 28810 is distinctive from code 28820, which only covers the amputation at the metatarsophalangeal joint.