I could really use some professional assistance with this case.
Preoperative Diagnosis: Osteo left 3rd toe
Procedure: Amputation left 3rd toe
toe where an amputation was done at the level of the mid proximal phalanx using a bone cutter that is specimen was then removed sent to
pathology the wound was then irrigated with Betadine and closed with 3-0 Vicryl and 5 0 nylon for skin dry dressing was then applied and
patient taken to recovery room in satisfactory condition.
Preoperative Diagnosis: Osteo left 3rd toe
Procedure: Amputation left 3rd toe
Description of the procedure:
Under general anesthesia foot was prepped and draped in routine manner an elliptical incision was made in the base of the left 3rdtoe where an amputation was done at the level of the mid proximal phalanx using a bone cutter that is specimen was then removed sent to
pathology the wound was then irrigated with Betadine and closed with 3-0 Vicryl and 5 0 nylon for skin dry dressing was then applied and
patient taken to recovery room in satisfactory condition.
- What would be the most appropriate code for what looks like transection as the middle portion of the proximal phalanx?
- It does not appear it was at a joint so 28820 would not be accurate.
- Would 28124 be accurate?
- Code 28124 doesn't seem appropriate by the lay descriptor.
- Why doesn't there seem to be a code for transphalangeal like there is transmetatarsal (28805)? Although, that code is all of the toes, not just the 3rd toe.
- Would 28150 (Phalangectomy, toe, each toe) or 28160 (Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each) be appropriate?
- I have read in an article that code 28810 (Amputation, metatarsal, with toe, single) used for the ray amputation is used for partial or complete metatarsal with the toe.
- Is there some verbiage similar for the 28820 (metatarsophalangeal joint) or 28825 (interphalangeal joints)? Their lay descriptors indicate capsulotomy is completed. Am I stuck with unlisted for these types of cases? Reputable references are appreciated such as CPT Assistant etc. Most of the amputation codes do not have CPT Assistant articles.
- Possible answer:Based off of Coding Clinic for HCPCS, Second Quarter 2023, May 17, 2023 I believe code 28825 would be the code for my example above. Due to copyrights, I won't post the entire thing, only the answer:
- "ANSWER
- For facility reporting, assign CPT code 28825, Amputation, toe; interphalangeal joint, for the partial amputation of the second toe. The documentation stated the incision was placed at the proximal interphalangeal joint and the remaining distal toe was resected. Additionally, append modifier T1, Left foot, second digit."
- "ANSWER
- Does anyone else agree?
