Multiple modifications and deletions of the CPT codes that many of us use for first ray repair surgery went into effect January 1, 2017. Here is a summary of what you need to know.
- All proper names have been eliminated from these code descriptions. If you use a billing service and the service is reading your dictated operative notes in order to determine which first ray code to use, do not use only proper names to identify the procedure. They will not be able to find the code for an “Austin” bunionectomy in the 2017 CPT codes.
- The CPT codes 28290, 28293 and 28294 have been deleted. These no longer exist. Never use them again.
- Code CPT 28296 was modified to: Bunionectomy with distal metatarsal osteotomy.
- CPT 28295 is a new code. The description is “bunionectomy with proximal metatarsal osteotomy.”
- Code CPT 28289 has been modified to specify “hallux rigidus repair without implant.”
- CPT 28291 is a new code. The description is “hallux rigidus repair with implant.”
Dr. Lehrman is on the APMA Coding Committee, serves as an expert panelist on Codingline.com and is a Fellow of the American Academy of Podiatric Practice Management (AAPPM). Follow him on Twitter @DrLehrman
2017 Changes to Bunion Codes
This code was deleted. CPT code 28290 represented a Silver bunionectomy or simple exostectomy of the medial eminence. Parenthetical notes in the CPT manual instruct coders to report 28292 when this type of procedure is performed.
This code was revised and along with the Silver bunionectomy, you would report 28292 for a Modified McBride or with resection of the base of the proximal phalanx (Keller type procedure).
This code was deleted. When an implant is placed at the first metatarsophalangeal joint you should report CPT code 28291 – Hallux rigidus correction with implant. This code is only reported for procedures performed on the first MTPJ and you should confirm what types of implants meet medical necessity because there are many types of joint implants that carriers consider experimental or investigational when used.
This code was deleted. This code used to represent a Joplin procedure which involved tendon transfers. If performed, parenthetical notes instruct the coder to report Unlisted CPT code 28899.
28295 – 28296
CPT code 28295 is a new code which represents a proximal metatarsal osteotomy that is performed at the base of metatarsal whereas CPT code 28296 is a distal metatarsal osteotomy performed at the head of the metatarsal bone.