Podiatry Coding & Billing Alert

Question: Can I report a hallux limitus release and an Austin bunionectomy in the same session?

Maine Subscriber

Answer:  No, you may not. It's an issue that commonly trips up podiatry coders.

While the two conditions often occur together and involve separate problems, the cheilectomy is really a component of the Austin bunionectomy, 28296 (Correction, hallux valgus [bunion], with or without sesamoidectomy; with metatarsal osteotomy [e.g., Mitchell, Chevron, or concentric type procedures]).

Here's why: In the bunionectomy, the podiatrist tackles the problem with the angle of the joint and involves one or more of the following procedures: osteotomy, tendon transfer, joint implant, and joint fusion.

With hallux limitus (ICD-9 code 735.2, Acquired deformities of toe; Hallux rigidus), meanwhile, the toe is rigid and has very limited range of motion. To correct the problem, the podiatrist performs a cheilectomy to clean up the first MTJ and restore mobility to the toe.

The reason a cheilectomy is part of the Austin is that a cheilectomy is basically remodeling the dorsal portion of the metatarsal head, and that occurs in an Austin bunionectomy osteotomy when the podiatrist has to dissect the capsule off the dorsal metatarsal head for exposure to the joint. The two procedures require the same soft-tissue dissection of the MTJ.

Therefore, you may only code the Austin bunionectomy on one line as 28296-TA.