Podiatry Coding & Billing Alert

Question: My podiatrist performed just a tenotomy for a reducible hammertoe deformity with all soft tissue and no bone involvement. He performed the tenotomy to reduce the deformity. How should I code this encounter?

New York Subscriber

Answer: Currently, you don’t have enough information to choose the appropriate tenotomy code. So, you must doublecheck your podiatrist’s medical documentation. Specifically, you need to know whether your podiatrist performed a percutaneous or an open tenotomy. You also need to know if this was an extensor or flexor tendon.

For a percutaneous tenotomy, you should look to the following codes:

• 28010 (Tenotomy, percutaneous, toe; single tendon). Report 28010 when the podiatrist performs a percutaneous tenotomy with a very small incision often referred to as a stab incision over a single extensor — the top of the foot usually at the metatarsophalangeal joint (MPJ) tendon.
• 28011 (Tenotomy, percutaneous, toe; multiple tendons). Report 28011 when the podiatrist performs a percutaneous tenotomy to incise or divide multiple tendons in a toe through a small incision in the skin to correct the hammertoe.

For open tenotomies, you would look to the following codes:

• 28230 (Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)). This service is an open tenotomy of a single or multiple tendon of the flexor tendon(s), the bottom of the foot.
• 28232 (…; toe, single tendon (separate procedure)). With this procedure, the podiatrist cuts into or through a single flexor tendon of the toe using an open incision during the performance of a more extensive procedure. Don’t miss: Report 28232 for the division of a tendon on the toe, not the foot, through an open incision. Report 28232 for each specific flexor tendon.
• 28234 (Tenotomy, open, extensor, foot or toe, each tendon). The podiatrist performs an open tenotomy of an extensor tendon of the foot or toe during this procedure.