Podiatry Coding & Billing Alert

Question: How should I code a crescent shelf osteotomy for a hallux valgus case? New York Subscriber Answer: You have two coding options to choose from when reporting this service. One option is to use 28296 (Correction, hallux valgus [bunion], with or without sesamoidectomy; with metatarsal osteotomy [e.g., Mitchell, Chevron, or concentric type procedures). The second option is to select 28306 (Osteotomy, with or without lengthening, shortening, or angular correction, metatarsal; first metatarsal). In a crescentic osteotomy procedure, the proximal portion of the first metatarsal is the subject of the osteotomy. The descriptor for 28306 more closely matches the procedure for a crescentic osteotomy. The procedure requires fixation, and the patient must keep weight off the foot for several weeks. According to the Coders Desk Reference, code 28306 represents a procedure in which "weight bearing is protected for several weeks" -- similar to a crescentic osteotomy. No mention of this weight-bearing [...]