Podiatry Coding & Billing Alert

Question: I am new to podiatry. Can you explain the difference between calcaneal and talus fractures? Which codes should I use for calcaneal and talus fracture repairs?

California Subscriber

Answer: The calcaneus is located at the bottom of the foot and part of the heel. On the other hand, the talus sits above the calcaneus and at the bottom of the ankle joint. Calcaneus fractures are the most common, while talus fractures are more difficult to heal due to the weak blood supply of the talus.

When the patient fractures both the talus and the calcaneus, this is defined as a hindfoot fracture.

Calcaneal fracture repairs: You’ll choose from one of the following codes for calcaneal repairs, depending on the encounter specifics:

• 28400 (Closed treatment of calcaneal fracture; without manipulation)
• 28405 (… with manipulation)
• 28406 (Percutaneous skeletal fixation of calcaneal fracture, with manipulation)
• 28415 (Open treatment of calcaneal fracture, includes internal fixation, when performed)
• 28420 (… with primary iliac or other autogenous bone graft (includes obtaining graft).

Talus fracture repairs: For talus fractures, you would turn to these codes:

• 28430 (Closed treatment of talus fracture; without manipulation)
• 28435 (… with manipulation)
• 28436 (Percutaneous skeletal fixation of talus fracture, with manipulation)
• 28445 (Open treatment of talus fracture, includes internal fixation, when performed)
• 29892 (Arthroscopically aided repair of large osteochon­dritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy).