Orthopedic Coding Alert

Question: In a patient diagnosed with osteomyelitis of left second metatarsal bone, our surgeon did a procedure which was described as below:

"A plantar incision was made over the base of the second metatarsal and draining wound. The edges of skin were meticulously maintained for hemostasis. The sinus tract was removed. The second metatarsal bone was identified at the level of the metatarsal head and traced proximally. Retractors were placed around the metatarsal and an osteotomy was used to resect the metatarsal bone and remove the margins far past the MRI portion of bone that demonstrated osteomyelitis. The bone was resected and passed off for biopsy."

How do we report this procedure?

Ohio Subscriber

Answer: Your surgeon is excising a part of the second metatarsal bone after confirming the extent of osteomyelitis on MRI. This is thus a partial excision. You report code 28122 (Partial excision [craterization, saucerization, sequestrectomy, or diaphysectomy] bone [e.g., osteomyelitis or bossing]; tarsal or metatarsal bone, except talus or calcaneus) for this procedure.