Podiatry Coding & Billing Alert

Question: I am new to podiatry and I need help with billing tenotomy cases. How many times can I report 28010 per foot? Also, the provider is reporting 28234 in addition to 28010. Should I report both?

Illinois Subscriber

Answer: You can report both codes -- 28234 (Tenotomy, open, extensor, foot or toe, each tendon) and 28010 (Tenotomy, percutaneous, toe, single tendon) -- but only if your podiatrist performed the procedures on different tendons.

Here's why: Both 28234 and 28010 are tenotomy procedures to correct a hammertoe. During a tenotomy, the tendon is cut entirely or partway through, allowing reduced or lessened tension at the site involved. Podiatrists may perform tenotomy through the skin (percutaneous) or by surgically exposing the tendon (open). In 28234, the physician makes a small incision on the crease of the dorsal toe on the top of the foot and releases the extensor tendon. In 28010, the podiatrist makes the incision on the crease of the toe where the tendon is restricted. Since the procedures differ, you can only use one or the other for a single tendon because a podiatrist would never perform both procedures to treat one tendon.

But you can use each code more than once if your podiatrist performs the procedures on multiple digits during the same surgery. You will have to indicate which toe your podiatrist operated on by appending modifier LT (Left) or RT (Right), and append modifier 59 (Distinct procedural service) to indicate that your podiatrist separately performed each procedure.