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Podiatry Coding & Billing Alert

Reader Question:

28296 and 64450 Are Inseparable

Published on Mon Sep 24, 2012

Question: I billed 28296 for a bunion correction with metatarsal osteotomy, and 64450 for the peripheral nerve block. The payer denied my claim saying 64450 was incidental. Can I use a modifier to get paid separately for this?

Georgia SubscriberAnswer: You have two things to consider for use of a modifier: Did the podiatrist operate on separate sites? Did he perform the nerve block for a separate procedure? FYI, The National Correct Coding Initiative (CCI) has bundled nerve blocks into bunionectomies since 2002.These edits have a status indicator of "1," meaning that you are able to unbundle them using modifier 59 (Distinct procedural service), but only if the podiatrist performed the two procedures on different sites or at different sessions.Heads up: You cannot separate 28296 (Correction, hallux valgus [bunion] with or without sesamoidectomy; with metatarsal osteotomy [e.g., Mitchell, Chevron, or concentric type procedures]) and 64450 (Injection, anesthetic agent; other peripheral nerve [...]
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