Podiatry Coding & Billing Alert

Question:A podiatrist performed two osteotomies on the patient's right foot -- one on the second metatarsal, and one on the third metatarsal. I don't know whether to report 28299 for a double osteotomy, 28309 for multiple osteotomies, or whether I should just report 28308 twice. And if I report 28308 twice, do I need modifier 59?North Carolina SubscriberAnswer:First, you need more details on the nature of the procedure. Most likely, you can scratch 28299 (Correction, hallux valgus [bunion], with or without sesamoidectomy; by double osteotomy) because your podiatrist's procedure is not a hallux valgus correction and doesn't fit under any of CPT's hallux valgus correction codes.A hallux valgus correction would involve an osteotomy of the first metatarsal -- not of the second and third. And a "double osteotomy," according to 28299, means that the doctor did two osteotomies on the same metatarsal, not two separate metatarsals.Because your op note fits [...]