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Podiatry Coding & Billing Alert

You Be the Coder:

Look Beyond 28285 for Hammertoe Correction

Published on Tue Dec 30, 2014

Question: Our physician performed a partial phalangectomy on right fifth toe with a syndactylization on right fourth and fifth toes. The physician suggested codes 28150 and 28280. Codes 28153 or 28126 are also viable options. How should I code this procedure? 

DX: Right fifth hammertoe

-- Made Triangular type incisions on the opposing surfaces of the fourth and fifth toes. Made an incision right in the midline of the proximal phalanx going out to the PIP joint. Entered and performed dissection in the PIP joint exposing the distal aspect of the proximal phalanx. Removed this with a bone biter. I then did the syndactylization by using a 4-0 nylon and first putting a suture into the apex of those two triangles and them closing the plantar arm and then dorsal arm.

Mississippi Subscriber

Answer: Based on your description, you should use 28280 (Syndactylization, toes [e.g., webbing or Kelikian type procedure]) for syndactylization. The physician may use a syndactylization any time an operated toe appears too floppy. Another option is amputation of the distal phalanx. You can code 28126 (Resection, partial or complete, phalangeal base, each toe) for partial phalangectomy from distal aspect of proximal phalanx.
 
Code 28150 (Phalangectomy, toe, each toe) is more appropriate if the physician identifies, exposes, and completely removes the affected phalanx using a bone saw. The provider then closes the surgical area in layers.
 
Code 28153 (Resection, condyle[s], distal end of phalanx, each toe) is applicable only when the provider surgically removes the condyle at the distal end of the phalanx, which amputates the toe.

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