Podiatry Coding & Billing Alert

Question: My podiatrist carried out a tenotomy procedure to correct a hammertoe deformity that was reducible and involved only soft tissue, with no bone involvement. The tenotomy was performed to lessen the deformity. How should I code this encounter?

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Answer: There isn’t sufficient information in your question as you ask it to accurately select the correct tenotomy code. Therefore, it will be necessary to revisit your podiatrist’s medical records for more information. Specifically, you need to know whether your podiatrist performed a percutaneous or an open tenotomy. You also need to know if the podiatrist performed the surgery on an extensor or flexor tendon.

For a percutaneous tenotomy, you should look to the following codes:

• 28010 (Tenotomy, percutaneous, toe; single tendon). Use this code when the podiatrist performs a percutaneous tenotomy with a very small incision, often referred to as a stab incision, over a single extensor — the top of the foot usually at the metatar­sophalangeal joint (MPJ) tendon.
• 28011 (Tenotomy, percutaneous, toe; multiple tendons). Use this code when the podiatrist performs a percutaneous tenotomy to incise or divide multiple tendons in a single toe through a small incision in the skin to correct the hammertoe.

For open tenotomies, you would look to these codes:

• 28230 (Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)). Use this code when the podiatrist performs an open tenotomy of either a single or multiple tendons of the flexor tendon(s), located at the bottom of the foot.
• 28232 (…; toe, single tendon (separate procedure)). Use this code when the podiatrist cuts into or through a single flexor tendon of the toe using an open incision during the performance of a more extensive procedure. Don’t miss: Report 28232 for the division of a tendon on the toe, not the foot, through an open incision. Report 28232 for each specific flexor tendon.
• 28234 (Tenotomy, open, extensor, foot or toe, each tendon). Use this code when the podiatrist performs an open tenotomy of an extensor tendon of the foot or toe during this procedure.