Podiatry Coding & Billing Alert

Question: When coding multiple hammertoe correction, should I submit 28285 with the appropriate modifiers for each toe?

Louisiana Subscriber

Answer: Yes, you'll want to include the appropriate modifiers for each toe that you code with 28285 (Correction, hammertoe [e.g., interphalangeal fusion, partial or total phalangectomy]).

Modifier choices: Coders often wonder whether to append modifier 59 (Distinct procedural service) or specific T modifiers (such as TA, Left foot, great toe; or T5, Right foot, great toe) for multiple hammertoe corrections. Either option should be acceptable, but know your carrier guidelines and only report one or the other, not both.

Remember: T modifiers are anatomic modifiers, and you can only report one anatomic modifier per line item. They are traditionally used for ASC or outpatient facilities and have only been approved for physician billing in recent years. Therefore, you may still have difficulty with some carriers accepting T modifiers from physicians. Check your carrier guidelines and be ready with supporting documentation if needed.