Podiatry Coding & Billing Alert

Question: I’m new to coding and trying to understand the difference between codes 28606 and 28615. Can you please help me?

Louisiana Subscriber

Answer: Both codes you mention are procedures the podiatrist performs to treat a tarsometatarsal joint dislocation, which is abnormal separation of a joint.

28606: During a 28606 (Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation) procedure the provider treats a tarsometatarsal joint dislocation. First, he performs a separately reportable X-ray to examine the dislocated joint. Then, he manually adjusts the bones by pushing or pulling to bring them back to their normal alignment. Next, he creates a small incision in the skin over the dislocated joint and inserts pins and screws through this incision to hold the reduced dislocation in place. Finally, he closes the wound by suturing the skin. Lastly, he places the patient’s foot in a splint or brace for a period of four weeks.

28615: On the other hand, in a 28615 (Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed) procedure, the podiatrist performs open treatment of the tarsometatarsal joint dislocation. During this procedure, the podiatrist makes an incision in the skin over the dislocated joint. He then dissects down through the subcutaneous tissue, protecting the nerves and vessels. Next, he retracts the muscles to have adequate exposure of the dislocated bones and adjusts the bones to reduce the dislocation. He then fixes the reduced joint with an implant and closes the wound by suturing the skin layers together. Lastly, he places the foot in a splint or brace for a period of four weeks.