Podiatry Coding & Billing Alert

Question: The podiatrist surgically corrected the patient's hallux rigidus deformity without using an implant. He also performed a cheilectomy. Which CPT^® codes should wereport?

Ohio Subscriber

Answer: When the podiatrist surgically corrects a hallux rigidus deformity without the need for an implant, you should report 28289 (Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant).

For this procedure, the podiatrist performs a cheilectomy, along with a debridement and capsular release of the metatarsophalangeal joint to free tightened connective tissue and loosen the ball and socket joint.

"The procedure involves the resection of osteophytic proliferation, including any fragmentation at the dorsal distal aspect of the first metatarsal and/or dorsal proximal phalanx base with secondary remodeling of bone on the medial and/or lateral aspects of both the first metatarsal head and base of the proximal phalanx," according to CPT^® Assistant in Vol. 26, No. 12. "Any adhesions involving the sesamoid apparatus are released."

Once that dorsal ostephytic block is removed, then the patient's range of motion in the joint should show a marked improvement, CPT^® Assistant adds.

Hallux rigidus definition: When a patient has hallux rigidus, he experiences arthritic changes of his joint of the big toe or the joint where the head of the metatarsal bone attaches to the first bone of the greater toe. Hallux rigidus can cause the patient pain, stiffness, and restriction of movement.