Orthopedic Coding Alert

Reader Question:

Report 28730 Once for 3 Joints

Question: Our orthopedist performed fusions to the first, second and third tarsometatarsal joints of the right foot. Is 28740 (Arthrodesis, midtarsal or tarso-metatarsal, single joint) the correct code? Should I report it three times with modifier -51 (Multiple procedures) appended to each listing? Can I separately report the ipsilateral calcaneal bone autograft?

Missouri Subscriber

Answer: You should report 28730 (Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse) for the fusions. Because the code descriptor includes the term "multiple," you do not need to list it more than once or to append any modifiers.
 
If the orthopedist harvested the autograft from a distant site (such as the opposite foot), you should separately report 20900 (Bone graft, any donor area; minor or small [e.g., dowel or button]). If he harvested it from the same foot as the arthrodesis, you should not separately report the graft harvest.
 
  - You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopaedic Associates in New Brunswick, N.J.

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