Advanced Search

Podiatry Coding & Billing Alert

Reader Questions:

Yes, CCI does allow 28110 with 28285

Published on Fri Jul 17, 2009

Question: What factors should we consider about billing 28110 with 28285? Wisconsin Subscriber Answer: CPT guidelines consider 28110 (Ostectomy, partial excision, fifth metatarsal head [bunionette] [separate procedure]) as a separate procedure, and there are no CCI edits pertaining to the procedures you mention. AAOS also does not warn of any bundling issues. Here's what happens: Your physician performs 28285 (Correction, hammertoe [e.g., interphalangeal fusion, partial or total phalangectomy]) in the proximal interphalangeal joint and 28110 on the metatarsal head. You should be able to report both procedures because they are two separate sites. Before you file: Because you're coding for both procedures, verify with the carrier whether you should append modifier 59 (Distinct procedural service) to complete your claim.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Podiatry Coding & Billing Alert

View All