Coding for First Ray Surgery - apma.org

1 Coding for First Ray SurgeryJeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPCIra Kraus, DPM, FASPS, FACFAS, CSFACP roper Names in Procedures Silver, Keller, McBride, Mayo, Joplin, Mitchell, LapidusCPT 28290 Correction, hallux valgus (bunion), with or without sesamoidectomy; simple exostectomy(eg, Silver type procedure)CPT 28290 DeletedCorrection, hallux valgus (bunion), with or without sesamoidectomy; simple exostectomy(eg, Silver type procedure)CPT 28292 Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedureCPT 28292 RevisedCorrection, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedureCorrection, hallux valgus (bunionectomy), with or without sesamoidectomy, when performed; withresection of proximal phalanx base, whenperformed, any methodCPT 28292 CPT 28293 Correction, hallux valgus (bunion), with or without sesamoidectomy; resection of joint with implant CPT 28293 DeletedCorrection, hallux valgus (bunion), with orwithout sesamoidectomy.

2 Resection of jointwith implant See CPT 28291 CPT 28294 Correction, hallux valgus (bunion), with or without sesamoidectomy; with tendon transplants (egJoplin type procedure)CPT 28294 DeletedCorrection, hallux valgus (bunion), with orwithout sesamoidectomy; with tendontransplants (egJoplin type procedure)CPT 28296 Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, chevron, or concentric type procedure)CPT 28296 RevisedCorrection, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, chevron, or concentric type procedure)Correction, hallux valgus (bunionectomy), with or without sesamoidectomy, when performed; with distalmetatarsal osteotomy, any methodCPT 28296 CPT 28295 NewCorrection, hallux valgus (bunionectomy), with or without sesamoidectomy, when performed.

3 Withproximalmetatarsal osteotomy, anymethodCPT 28295 CPT 28298 Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalangeal osteotomyCPT 28298 RevisedCorrection, hallux valgus (bunion), with or without sesamoidectomy; by phalangeal osteotomyCorrection, hallux valgus (bunionectomy), with or without sesamoidectomy, when performed; withproximal phalanx osteotomy, any methodCPT 28298 CPT 28297 Correction, hallux valgus (bunion), with or without sesamoidectomy; Lapidus type procedureCPT 28297 RevisedCorrection, hallux valgus (bunion), with or without sesamoidectomy; Lapidus type procedureCorrection, hallux valgus (bunionectomy), with or without sesamoidectomy, when performed; with firstmetatarsal and medial cuneiform jointarthrodesis, any methodCPT 28297 CPT 28299 revisedCorrection, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy Correction, hallux valgus (bunionectomy), with or without sesamoidectomy, when performed.

4 With double osteotomy, any methodCPT 28299 CPT 28299 CPT 28299 Osteotomy vs. OstectomyCPT 28306 Osteotomy, with or without lengthening, shortening, or angular correction, metatarsal; First metatarsalCPT 28310 Osteotomy, shortening, angular or rotational correction; proximal phalanx, First toe (separate procedure)CPT 28740 Arthrodesis, midtarsalor tarsometatarsal, single jointLapidusand Reverdin CPT 28296 and CPT 28740 Lapidusand Akin CPT 28298 and CPT 28740 Lapidusand Reverdinand Akin CPT 28299 and CPT 28740 CPT 28289 RevisedHallux rigiduscorrection with cheilectomy, debridement and capsular release of the First metatarsophalangeal joint Hallux rigiduscorrection with cheilectomy, debridement and capsular release of the First metatarsophalangeal joint.

5 Without implantCPT 28289 CPT 28291 NewHallux rigiduscorrection with cheilectomy, debridement and capsular release of the First metatarsophalangeal joint; with implantCPT 28291 CPT 28750 Arthrodesis, great toe; metatarsophalangeal jointHallux Varus Repair CPT 28313 Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes) CPT 28270 Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure) CPT 28310 Osteotomy, shortening, angular or rotational correction; proximal phalanx, First toe (separate procedure) CPT 28306 Osteotomy, with or without lengthening, shortening, or angular correction, metatarsal; First metatarsalThank You!

6 ! Coding for First Ray SurgeryJeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPCIra Kraus, DPM, FASPS, FACFAS, CSFAC