louise Posted Thu 14th of March, 2019 07:23:07 AM
Right hallux contracture at the interphalangeal joint. 2. Right 2nd toe contracture of the proximal interphalangeal joint. 3. Right 3rd toe contracture at the proximal interphalangeal joint and the metatarsophalangeal joint Coded as 28292 28285x2 28052 guidance is needed. incision was made at the medial hallux, identifying the previously-placed screw for the Akin osteotomy. screw was removed in its entirety from the right hallux. incision was made over the interphalangeal joint of the hallux. The dissection was carried down, with care to protect the extensor tendon. The head was identified severely contracted. Next, a sagittal saw was used to resect the articular surface of the proximal phalanx of the right hallux. sagittal saw was also used to resect the articular surface of the base of the distal phalanx. hallux reduced in proper alignment. Arthrex fully-threaded headless screw Two additional Arthrex screws were placed for additional fixation. 3rd toe, where an incision was made over the proximal interphalangeal joint The joint was noted to be severely contracted. An extensor tenotomy was performed, and the head of the proximal phalanx was exposed was resected with a sagittal saw. Next, the extensor digitorum brevis tendon was released. extensor tendon digitorum longus tendon was extremely contracted and preventing manual reduction of the metatarsophalangeal joint, so a Z tendon lengthening was performed. A Bio-Tenodesis screw was placed in the metatarsal head, holding the correction. The extra suture tape was cut. A C-wire was placed across the proximal interphalangeal joint, and the toe was noted to be in good alignment. 2nd toe, and an incision was made over the proximal interphalangeal joint. Extensor tenotomy was performed. The head of the phalanx was identified, and a revision arthroplasty of the 2nd toe was performed.
SuperCoder Answered Fri 15th of March, 2019 06:43:57 AM
As per the above mentioned operative note, the appropriate CPT codes are as follows:
28292 - T5
28285 - 59,T6
Note: 22 (Increased Procedural Services) will be added with CPT 28285 for third toe, as physician has also performed Z tendon lengthening.