lorettac
Networker
Dear Everyone, need some help on the correct CPT code be used.
Our podiatrist performed a Right Partial 1st Ray Amputation due to a hallux amputation performed months ago and developed a chronic wound to the hallux amputation stump on the right toe.
As per the Operating Report:
....Attention was then directed to the right foot where an incision down to bone was made around the circumference of the chronic wound. This was to excise all nonviable tissue from the wound edge. The incision carried on from the medial aspect of the wound proximally to roughly 50% down the 1st metatarsal shaft. It should be noted that the incision was taken down to the level of bone. All important neurovascular structures were retracted and all bleeders were cauterized or ligated as necessary. After all nonviable wound edges were excised, this tissue was passed to the back table in toto. It should be noted that fresh bleeding was visualized not only from the dermal layers but also the deeper subscutaneous layers. Once the incision was carried down to bone, a key elevator was utilized to reflect some of the soft tissue off the metatarsal shaft as well as the small piece of the proximal phalanx that was left over from the prior hallux amputation. The base of the proximal phalanx and the head of the 1st metatarsal were excised utilizing a sagittal saw and 15 blade and were passed to the back table in toto. At this time, it was noted that closure without any tension was not attainable and so one more small piece of the 1st metatarsal was excised. After the bone and soft tissue was excised to allow for full closure, the wound was copiously irrigated with sterile normal saline and the end of the metatarsal bone was palpated to ensure there were no sharp edges left....
Procedure performed: Right partial 1st ray amputation
As per the podiatrist picked the CPT 28288 (Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head) which I think this procedure is more for removal of bone spur, and I think CPT 28810 (Amputation, metatarsal, with toe, single) would be more appropriate for this condition. However, this procedure is only removal of part of metatarsal without toe, should I still be able to report this code? Or this is another appropriate code to use?
Thank you very much for any input! Appreciated!
Our podiatrist performed a Right Partial 1st Ray Amputation due to a hallux amputation performed months ago and developed a chronic wound to the hallux amputation stump on the right toe.
As per the Operating Report:
....Attention was then directed to the right foot where an incision down to bone was made around the circumference of the chronic wound. This was to excise all nonviable tissue from the wound edge. The incision carried on from the medial aspect of the wound proximally to roughly 50% down the 1st metatarsal shaft. It should be noted that the incision was taken down to the level of bone. All important neurovascular structures were retracted and all bleeders were cauterized or ligated as necessary. After all nonviable wound edges were excised, this tissue was passed to the back table in toto. It should be noted that fresh bleeding was visualized not only from the dermal layers but also the deeper subscutaneous layers. Once the incision was carried down to bone, a key elevator was utilized to reflect some of the soft tissue off the metatarsal shaft as well as the small piece of the proximal phalanx that was left over from the prior hallux amputation. The base of the proximal phalanx and the head of the 1st metatarsal were excised utilizing a sagittal saw and 15 blade and were passed to the back table in toto. At this time, it was noted that closure without any tension was not attainable and so one more small piece of the 1st metatarsal was excised. After the bone and soft tissue was excised to allow for full closure, the wound was copiously irrigated with sterile normal saline and the end of the metatarsal bone was palpated to ensure there were no sharp edges left....
Procedure performed: Right partial 1st ray amputation
As per the podiatrist picked the CPT 28288 (Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head) which I think this procedure is more for removal of bone spur, and I think CPT 28810 (Amputation, metatarsal, with toe, single) would be more appropriate for this condition. However, this procedure is only removal of part of metatarsal without toe, should I still be able to report this code? Or this is another appropriate code to use?
Thank you very much for any input! Appreciated!