Podiatry Coding & Billing Alert

Question: My podiatrist made an incision over the patient’s metatar­sophalangeal (MTP) joint. They clamped and coagulated small vessels along the path and released soft tissue structures as needed. My podiatrist also removed the enlarged bump of bone on the side of the foot. They then used a separate incision to access the joint between the first metatarsal and medial cuneiform. My podiatrist entered the joint capsule and aligned the metatarsal and cuneiform bones to be in the target position. They used fixation devices to hold the bones in the desired fused position. My podiatrist also performed a sesamoidectomy. Lastly, he checked for bleeding and closed the incision. Which CPT^® code should I report for this procedure?

Wisconsin Subscriber

Answer: You should report 28297 (Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method) for this procedure.

Don’t miss: Your podiatrist will perform a 28297 procedure “to correct a hallux abductovalgus deformity with associated long first metatarsal, hypermobile first ray or instability in the first metatarsocuneiform joint, high medially deviated first metatarsocuneiform angle, arthritic changes in the first metatarsocuneiform joint, and/or failed first ray osteotomy,” according to CPT^® Assistant Volume 26, Number 11.

“Code 28297 includes the removal of prominent or hypertrophied bone from the medial aspect of the first metatarsal head (distal metaphysis) along with first metatarsal and medial cuneiform joint arthrodesis and may additionally include the resection of excess bone at the dorsomedial, dorsal, and/or dorsolateral aspect of the metatarsal head, and/or base of the proximal phalanx with or without related soft-tissue correction, resection, or release,” per CPT^® Assistant. “Code 28297 may also involve tendon and other soft tissue balancing and/or the removal of one or both sesamoids.”