Podiatry Coding & Billing Alert

Question: The podiatrist removed the bone of the second metatarsal head because the head had infection in it. To do this, the podiatrist made an incision at the second metatar­sophalangeal joint. He then dissected down through the subcutaneous tissue and removed the joint capsule and any diseased synovium. He exposed the metatarsal head and removed it completely. The podiatrist inserted pins into the metatarsal and the proximal phalanx of the toe to maintain the correct position. Which CPT^® code should I report for this procedure?

Hawaii Subscriber

Answer: You should report 28112 (Ostectomy, complete excision; other metatarsal head (second, third or fourth)) for this service.

Notice that the code descriptor for 28112 specifies that the podiatrist perform the ostectomy for the second, third, or fourth metatarsal head. So, if you read in the documentation that the podiatrist removed the bone of the first metatarsal head, instead, you should report 28111 (Ostectomy, complete excision; first metatarsal head). And, if the podiatrist removes the bone of the fifth metatarsal, you should report 28113 (Ostectomy, complete excision; fifth metatarsal head).