Podiatry Coding & Billing Alert

Question: Which CPT® code would I use if the podiatrist performed a navicular bone repair without manipulation? I didn’t see a particular code that referenced the navicular bone. Should I use an unlisted procedure code?

Nebraska Subscriber

Answer: You should actually report 28450 (Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each) for this procedure, not an unlisted procedure code.

According to the descriptor for 28450, the procedure performs closed treatment of a tarsal bone fracture, except the talus and calcaneus. The seven of the tarsal bones include the navicular, cuboid, medial cuneiform, intermediate cuneiform, lateral cuneiform, talus, and calcaneus. So, once you understand the anatomy terms, you can see that the navicular bone is a tarsal bone and would be covered under 28450.

Don’t miss: You cannot report 28450 for the treatment of the talus and calcaneus, even though they are tarsal bones, because the descriptor for 28450 specifies “except the talus and calcaneus.”

For talus fractures, you can look to 28430 (Closed treatment of talus fracture; without manipulation)-28445 (Open treatment of talus fracture, includes internal fixation, when performed).

And for calcaneus fractures, you can look to 28400 (Closed treatment of calcaneal fracture; without manipulation)-28420 (Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)).

Caution: According to the descriptor for 28450, this code does not include manipulation of the fractured. You would report 28455 (Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each) when the podiatrist performs closed treatment of a tarsal bone fracture, other than the calcaneus or talus, with manipulation.

Documentation tip: Fractures can be tricky to code. You must always check your podiatrist’s documentation for details such as the exact bone of the foot he treated, what type of fracture treatment he used (closed or open), whether he used manipulation or not, and whether he used internal fixation.