Wiki 28810 vs 28820

[kmartinez]

Please, Please help me solve this confusion I have regarding 28810 and 28820, I seem to never get these straight.

Procedure: Amputation, partial ray, left foot.

Procedure- ...full thickness incision down to bone around the hallux. Next, the toe was disarticulated with a 15 blade...necrotic tissue was debrided. Next attention was drawn over the medial side of the left first metatarsal where a full thickness incision was created down to bone. Blunt dissection used to release the metatarsal from the surrounding tissues. Next, a sagittal saw was used to create an oblique osteotomy of the first metatarsal and the approximately anterior 1/2 of the first metatarsal was sharply dissected from the area and taken for pathology. A wound culture was taken at this point and more necrotic tissue was identified including flexor hallucis longus tendon, which was protracted and transected from the wound. The first metatarsophalangeal joint was found to be devitalized. This was sharply dissected from the wound with a 15 blade....

Am I correct in coding this as 28810??

TIA
KAM

 

[Orthocoderpgu]

Yes, you are correct

28810 osteotomy is made through the metatarsal (ultimately in this case).

28820 the toe is separated at the joint capsule from the MT

What may be throwing you off is that the doc performed the disarticulation at the MTP joint first (28820) and then afterwards performed the osteotomy through the MT (28820).

Don't know why it was done that way but that was your docs decision and why they get paid the big bucks.

 

[kmartinez]

28810 osteotomy is made through the metatarsal (ultimately in this case).

28820 the toe is separated at the joint capsule from the MT

What may be throwing you off is that the doc performed the disarticulation at the MTP joint first (28820) and then afterwards performed the osteotomy through the MT (28820).

Don't know why it was done that way but that was your docs decision and why they get paid the big bucks.

Thank you for your help and that input! Someday these won't confuse me soo much

KAM