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Os Trigonum

Lisa Posted Fri 09th of November, 2012 17:41:18 PM

Would the correct cpt for excision of os trigonum be "28120"?

SuperCoder Answered Mon 12th of November, 2012 02:50:56 AM

In most cases, the surgeon will make an incision behind the ankle, and once he identifies the os trigonum, he dissects it free of its surrounding soft-tissue attachment.For this procedure, most coders report 28120 (Partial excision [craterization, saucerization, sequestrectomy, or diaphysectomy] bone [e.g., osteomyelitis or bossing]; talus or calcaneus).In addition, the American Orthopaedic Foot and Ankle Society recommends reporting 28120 for os trigonum excisions.

But because CPT does not include a code for removing an accessory bone, your payer might scrutinize 28120 if the surgeon isn't dealing with osteomyelitis or other diseased bone conditions. If this is the case, report 28899 (Unlisted procedure, foot or toes) with good documentation explaining that the surgeon performed an excision of an accessory foot bone.

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