Wiki DIFFERENCE BETWEEN 28292-28298 AND 28300-28309 CODES

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RebeccaMoney

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These codes all show Osteotomy so I am confused. My physician states Akin Osteotomy, Chevron, and Lapidus done . He gives me 28297, 28310, and 28308. I'm thinking more like 28297, 28296, and 28298. Would somebody be willing to review the attached op note and tell me what you think the codes should be? My physician and I are both new to foot coding and need help. I appreciate any input. thank you,
 

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An Aikin is a wedge osteotomy of the proximal phalanx. Chevron is a V shaped osteotomy that allows the physician to slide the bone back into place. Lapid is performed at the mid-foot and an arthrodesis is performed to hold the metatarsal into place. I have never seen a chevron and a lapid used together. I have not read your op note yet.
 
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The first procedure performed was the Lapid (28297). I think this procedure qualifies for a -22 modifier. Because this was a revision procedure there was a lot more preparation done due to the previous procedure. It would have been nice for your surgeon to dictate how much additional time was taken. Then Akin was then done (28310). It hits an edit but since its performed through a separate incision and performed on a different bone I think it qualifies for a -59. I have never seen a chevron procedure performed on the 5th metatarsal, until now. Normally this would be coded 28110, however that's not the procedure that your surgeon performed. I think 28308 is actually a good code for what was done. 28297-22, 28310-59, 28308. Make sure you add your laterality modifiers and -51 as well.

Keep in mind that I am not adding the -22 simply because of the revision. Usually in a revision such as this the hardware is removed without much fuss and a little prep work done for the revision. After the hardware was removed it seemed that there was much more prep that needed to be done in this case.
 
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