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Podiatry Coding & Billing Alert

Surgery:

28285, 28315 Plus Proper Modifiers Equals Partial Sesamoidectomy and Hammertoe Claim Success

Published on Wed Jul 25, 2012

Open up your sesamoid coding options with these 3 tips.Coding for hammertoe correction and sesamoid planing separately can be complicated enough, but when the podiatrist has to combine the procedures, it can leave even the most experienced coders bewildered. Follow our experts' three steps below to help solve the following scenario:The podiatrist at a practice sees a patient -- with history of chronic sesamoiditis (733.99) of the right metatarsophalangeal joint and hammertoe (right third and fourth toes) -- for hammertoe correction and sesamoid planing of the metatarsophalangeal joint. The operative report indicates that only 40-50 percent of the sesamoid bone was removed. What should you report?1. Record Medical NecessityCosmetic surgery for the purpose of enhancing the appearance of the foot will not give you coverage in most insurance programs. Support medical necessity with:Appropriate diagnosis code to define persistent symptoms at the right metatarsophalangeal joint and hammertoe. In the above scenario, 733.99 best [...]
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