Wiki CPT for excision of os navicular + reattachment posterior tibial tendon

nsteinhauser

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"Attention was turned to the medial ankle. A new incision was made over the os navicular. Found the edge of the posterior tibial tendon and began dissecting it off the bone from superior to inferior. The os navicular was identified within the tendon. It was removed. It was attached to the posterior tibial tendon. Used an osteotome to resect the prominent navicular medially. C-arm image was obtained to make sure we removed the entire os as well as a portion of the navicular. The wound was copiously irrigated. C-arm fluoroscopy was used and drilled for the Smith and Nephew Q fix suture anchor. Impacted the Q Fix suture anchor in the middle of the navicular. Used the 2 arms to reapproximate the posterior tibial tendon back to the navicular."
I'm looked at 27658 for repair of the posterior tibial but that says 'LEG'. So then I went to 28200 for 'FOOT'. But then I think "is reattachment really REPAIR?" I don't have a 'strain' dx for the tendon repair but it had to be repaired after it was dissected off of the bone. Thinking 28304 for ostectomy of navicular. Removal of os navicular included in repair code for posterior tibial?
Thank you for any help.
 
"Attention was turned to the medial ankle. A new incision was made over the os navicular. Found the edge of the posterior tibial tendon and began dissecting it off the bone from superior to inferior. The os navicular was identified within the tendon. It was removed. It was attached to the posterior tibial tendon. Used an osteotome to resect the prominent navicular medially. C-arm image was obtained to make sure we removed the entire os as well as a portion of the navicular. The wound was copiously irrigated. C-arm fluoroscopy was used and drilled for the Smith and Nephew Q fix suture anchor. Impacted the Q Fix suture anchor in the middle of the navicular. Used the 2 arms to reapproximate the posterior tibial tendon back to the navicular."
I'm looked at 27658 for repair of the posterior tibial but that says 'LEG'. So then I went to 28200 for 'FOOT'. But then I think "is reattachment really REPAIR?" I don't have a 'strain' dx for the tendon repair but it had to be repaired after it was dissected off of the bone. Thinking 28304 for ostectomy of navicular. Removal of os navicular included in repair code for posterior tibial?
Thank you for any help.
I just found 28238. But now questioning can I separately code the 28304? or would that be considered part of the 28238 procedure?
Thanks!
 
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