Podiatry Coding & Billing Alert

Question: I have a podiatrist who wants to bill two bunionectomy codes together, 28295 (Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method) and 28298 (Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal phalanx osteotomy, any method), on the left TA big toe. My colleagues and I are under the impression that you can’t bill two bunionectomy codes together since you can only have and remove one bunion on each foot. My podiatrist did perform the bunionectomy and two osteotomies. I was thinking we need to report 28298 and 28310 (Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)) or 28299 (Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with double osteotomy, any method). Can you point me in the direction of a credible source (ie AAOS, AAPC, CMS) for documentation that I can present for my argument?

AAPC Forum Subscriber

Answer: You are correct about not being able to bill codes 28285 and 28298 together on the same foot. Code 28298 is a component of 28285 and cannot be billed separately. Codes 28298 and 28310 are also mutually exclusive since 28310 is a component of 28298. Based on your question, 28299 would be the correct way to bill this if your operative report documents that all the procedures were done. National Correct Coding Initiative (NCCI) is also an excellent source for these situations.