Orthopedic Coding Alert

Question: My physician's operative note says he performed an arthrodesis of the Lisfranc joint, including the medial and middle cuneiforms and first and second metatarsals. The patient had a previous arthrodesis, and the orthopedist used the previous incision, removed old hardware, and exposed the first and second metatarsal and middle and medial cuneiform. Should I report this with multiple units of 28740?

Michigan Subscriber

Answer: Although you might be tempted to use 28740 (Arthrodesis, midtarsal or tarsometatarsal, single joint), this isn't the most appropriate code.

Instead, you should report 28730 (Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse). The key word with this code descriptor is -multiple.- Because your orthopedist treated several joints in the same area, this is your best code choice.