Podiatry Coding & Billing Alert

Question: The podiatrist performed cheilectomy on the left toe for hallux rigidus. Any suggestions on CPT for bone diagnosis, excisional, first metatarsal?

Arizona Subscriber

Answer: You should use 28289 (Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint [MTP]) for the hallux rigidus (735.2) diagnosis.

Trap: Many practices confuse hallux rigidus with degenerative arthritis because they are synonymous. The actual cheilectomy surgical procedure is that of removing the bone from the 1st metatarsal head and base of the proximal phalanx. Bone spurs can be caused by arthritis -- the reason, perhaps, for the confusion. Report the appropriate arthritis ICD-9 code for osteoarthritis or degenerative arthritis (715.90) when the medical record reflects this.