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Podiatry Coding & Billing Alert

Reader Questions: Unlisted Codes Fare Best For Hallux Limitus

- Published on Tue, Jul 20, 2010
Question: My podiatrist performed a joint replacement for hallux limitus on a patient who does not have a bunion. I think I should use 28293, but my podiatrist thinks otherwise. What is the code to use for this procedure?Kentucky SubscriberAnswer: Your podiatrist is right to disagree. You will not find a CPT for hallux arthroplasty with implant, and your best option is to useunlisted codes.Here's what you should do: report 28899 (Unlisted procedure, foot or toes). When you determine a comparison code for the most accurate reimbursement, compare the unlisted code 28899 to 28289 (Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint) or 28293 (Correction, hallux valgus [bunion], with or without sesamoidectomy; resection of joint with implant) when submitting your claim.

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