Wiki Bunionectomy with metatarsal osteotomy

[Ksumansky]

I was wondering if someone could look at this and see if they agree with my code or not. Thanks

PreOp/PostOp: Hallux Limitus first left

Operation: Bunionectomy with metatarsal osteotomy first left.

Procedure: .........Attention was then directed to the first metatarsophalangeal joint where 5 cm linear skin incision was made. This incision was deepened down through subcutaneous tissue, taking care not to disrupt any neurovascular bundles. The spurring affect was identified and the dorsal lateral aspect of the metatarsal head was removed in toto. The medial eminence was removed in toto. One 60 degree cut was made from medial to lateral and a second cut was made to the head of the proximal phalanx. The head was transposed 4 mm plantar lateral. One 0.045 k-wire was driven from dorsal proximal medial plantar distal lateral and laid upon the bone. The remaining stump of metatarsal was removed in toto. The area was flushed with copious amounts of sterile saline. 3-0 vicryl awas utilized to appose the capsule and subcutaneous tissue. 4-0 vicryl was utilized to appose the skin in a subcuticular fashion.........

ICD9 code: 735.8
Cpt code: I am taking a guess here.......28296-LT

 

[nswanson2]

I would say using 735.8 is too generic due to the lack of specificity and may result in the claim getting held up and/or denied. If it is the most specific code the insurance company may request more info to prove medical necessity. The procedure code looks fine to me though.

 

[00029754]

I would code 28299 if cuts were to MT and phalange