the procedure on the op report states, "Amputation at the transmetatarsal level of the great toe with partial toe fillet flap." So, my question is, can they be billed together since they are both for the feet/toe, or is one combined with the other?
Well, by definition "transmetatarsal" refers to amputation of all toes at the metatarsals, which is 28805. The narrative is a little confusing, because I'm not understanding what the surgeon means by "transmetatarsal
level" of the great toe. Is there any more information as to what exactly was amputated?
To try to help answer your question, try to think of it like this in super generic terms:
28805 Amputation, foot; transmetatarsal - you have a zip-lock baggie with candy in it. you open it up, take out the candy, then zip it closed again using the existing zipper. it's KINDA like that. there's really no need for anything else to close it up.
14350 Filleted finger or toe flap, including preparation of recipient site - they literally slice your finger or toe open from top to bottom, like a hot dog bun. then everything is taken out (bones, tissues, etc) and the remaining skin is the "flap".
Why would there be the need to create the flap from a toe (which would have been removed) if the skin to close the stump already existed? Do you know what I mean?