Orthopedic Coding Alert

Question: The surgeon performed an ostectomy/bunionectomy and osteotomy of the fifth toe. Can we code for both procedures?

Louisiana Subscriber

Answer: National Correct Coding Initiative edits bundle 28308 (Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each) and 28110 (Ostectomy, partial excision, fifth metatarsal head [bunionette] [separate procedure]) when a surgeon completes both procedures on the same toe. If Medicare is the patient's primary carriers, you can only report 28308 if the surgeon performs both procedures on the same toe. Some other payers, however, allow you to report both codes if your surgeon includes sufficient documentation of each procedure or if he treats separate toes. If so, append modifier 59 (Distinct procedural service) to 28110 on the claim.

-- Reader Questions and You Be the Coder were reviewed by Heidi Stout, CPC,CCS-P, director of orthopedic coding services at The Coding Network LLC; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.