Podiatry Coding & Billing Alert

Question: I reported 28299 for a "tricorrectional" bunionectomy, but the claim was denied. What points did I miss? Wisconsin Subscriber Answer: A tricorrectional bunionectomy -- sometimes referred to as a Reverdin-Green- Laird bunionectomy -- falls under 28296 (Correction, hallux valgus [bunion], with or without sesamoidectomy; with metatarsal osteotomy [e.g., Mitchell, Chevron, or concentric type procedures]), and not 28299. Why? Because 28299 only involves a double osteotomy. What goes on: A tricorrectional bunionectomy occurs when the podiatrist performs a metatarsal osteotomy along with the bunionectomy. He first resects the medial eminence of the first metatarsal head, removing the bony prominent enlargement, or bunion. He then cuts though the metatarsal and repositions the metatarsal head on the metatarsal shaft, fixating the newly aligned bones with a screw fixation.