Orthopedic Coding Alert

Question: Operative notes indicate that the provider performed tarsometatarsal arthrodesis. How should I report this service?

Illinois Subscriber

Answer: Your code choice will depend on some more details that you can (hopefully) get from the operative notes. The codes for tarsometatarsal arthrodesis are:

• 28730 - Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse
• 28735 - ... with osteotomy (eg, flatfoot correction)
• 28740 - Arthrodesis, midtarsal or tarsometatarsal, single joint.

Do this: Go back and check the notes for evidence of the type of tarsometatarsal arthrodesis your provider performed. If you look closely enough, you just might be able to figure out the type of procedure and, thus, the appropriate code.

Another option: If you just want to cut to the chase, you can ask the provider what type of tarsometatarsal arthrodesis she performed. You might also want to let the provider know that more detail might be necessary in the op note; if you cannot identify the procedure from the notes, payers might have issue with forking over full reimbursement.

Warning: You need to be vigilant on the documentation for this claim. If the notes do not specify the tarsometatarsal joint that the surgeon fused, this is a documentation deficiency and the surgeon must revise the operative report.