Tanesha Posted Wed 11th of October, 2017 13:12:49 PM
Pt. has flexible hammertoes, but no bony work was performed (phalangectomy,etc.) but tendon a flexor transfer was performed and capsulotomy. Would it be more appropriate to code 28313 as only soft tissue work performed although 28285 is specifically for hammertoe? Excerpt below:
Attention was then turned to the 2nd hammertoe. A dorsal incision was made from just distal to the PIP joint and extended just proximal to the MTP joint. The long toe extensor was lengthen in a Z-fashion.The MTP joint was sharply opened, thus performing a capsulotomy. A McGlamory elevator was then used to free up the MTP joint plantarly. The extensor mechanism at the PIP joint was then Incised In its midline. A medial incision was placed on the toe. Sharp dissection was then carried out down to the flexor tendons. The short flexor tendons were sharply tenotomized. The long flexor tendon was dissected out to its insertion on the distal phalanx. This was then transected. A mosquito hemostat was then placed Through the dorsal split of the extensor tendon and brought down into the medial incision around the medial aspect the proximal phalanx. The long toe flexor was transferred to the mosquito and brought up to the dorsal aspect of the toe. A K-wire was then driven in a retrograde fashion from the tip of the toe into the metatarsal head with the toe anatomic alignment. The flexor tendon transfer was then tensioned and sewn in place using 2-0 Ticron suture. The long toe extensor lengthening was then repaired with 2-0 Ticron suture in a lengthened state. The wire was bent and cut external to the toe.
SuperCoder Answered Thu 12th of October, 2017 09:11:52 AM
The appropriate code to bill for the above procedure will be 28313. We will also bill CPT 28272, as this procedure includes capsulotomy as well as long toe extensor lengthening. Please fell free to ask for any further query. Thank you.
Tanesha Posted Thu 12th of October, 2017 11:25:00 AM
Thank you for the timely response. But, Capsulotomy was performed on the MTP joint. Did you mean 28270?
SuperCoder Answered Fri 13th of October, 2017 00:37:38 AM
Yes it will be 28270 for capsulotomy performed on the MTP. Thank you.