Wiki Coding for complicated bunion correction

[Wendy McBride]

What would be the correct CPT coding for the following please:

A patient has a Lapidus-type procedure done, but the joint is fitted with a lateral plate after being packe with osteoinductive/osteoconductive bone graft with cancellous bone chips. The foot was irrigated, and there was still some deviation at the first matatarsophalangeal joint with sesamoid positions being slightly lateral to central.

The op report then states "an Austin bunionectomy was then performed with an OrthoSorb pin secured in place without incident with Chevron osteotomy being slightly longer."

Wound irrigated incisions reapproximated and dressed.

I'm a little stumped, I can't find any coding that actually matches what was done... Help!

 

[PLAIDMAN]

What would be the correct CPT coding for the following please:

A patient has a Lapidus-type procedure done, but the joint is fitted with a lateral plate after being packe with osteoinductive/osteoconductive bone graft with cancellous bone chips. The foot was irrigated, and there was still some deviation at the first matatarsophalangeal joint with sesamoid positions being slightly lateral to central.

The op report then states "an Austin bunionectomy was then performed with an OrthoSorb pin secured in place without incident with Chevron osteotomy being slightly longer."

Wound irrigated incisions reapproximated and dressed.

I'm a little stumped, I can't find any coding that actually matches what was done... Help!

I am not sure the dx? The Lapidus, osteotomy is included in the Lapidus, as well as fixation, and typically only the hospital is billing for allograft bone material supply.

His only option would be to charge the Lapidus code and append "22" modifier, you will have to either send cover letter or document in the op report why is was more difficult and how much more time it took- if you do not document why/time difficulty they will not pay you more.

 

[Wendy McBride]

Thank you kindly, I appreciate the guidance!