Podiatry Coding & Billing Alert

Reader Questions:

Dive Into This Arthrodesis Situation

Published on Mon Nov 15, 2021

Question: My podiatrist incised the skin over the affected joints in the front of the ankle. They dissected down through subcutaneous tissue, preserving the nerves and veins. They then retracted the muscle to gain access to the joints to be fused. Next, they incised the joint capsule and entered the joint. They removed all the dead tissue from the joint cavity. My podiatrist then removed a portion of the shaft bone of the metatarsal bone to correct the flat foot deformity. They brought the bones of the joints in close proximity and fused the joints using K wire. They performed this procedure on multiple joints and metatarsals. Finally, my podiatrist stopped all bleeding at the surgical site, irrigated the wound, and closed the wound by suturing the soft tissue in layers. The patient will be in an ankle cast for four to six weeks. Which code should I report for this procedure?

Alabama Subscriber

Answer: You should report 28735 (Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction) on this claim. You should report code 28735 when your podiatrist performs arthrodesis of multiple of transverse midtarsal or tarsometatarsal joints with an osteotomy.

Arthrodesis defined: If you see in the medical documentation that your podiatrist performed arthrodesis, then they surgically immobilized a joint by fusing bones. Your podiatrist can perform many different types of arthrodesis on a patient’s feet and toes.

Midtarsal joints defined: The midtarsal joints are the combined joints of either the talus with the navicular bone or the calcaneum with the cuboid bone.

Tarsometatarsal joints defined: Tarsometatarsal joints can also be called Lisfranc joints. They are the joints of the first, second, and third cuneiforms, and the cuboid with the bases of the metatarsal bones.

Don’t miss: If your podiatrist was to surgically immobilize multiple or transverse midtarsal or tarsometatarsal joints with the help of fixation devices without performing an osteotomy, you should report 28730 (Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse).