28315 and 28122 billed together

Lindseywingate1990

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Can your report 28315 with 28122 for excision og seasmoids with peartial excision of metatarsal head. they are not global but the 28315 is designated as a (seperate procedure) but the Doctor performs both and releases the seasmoid ligament which is not included in the 28122. thanks for any help!
 

nsteinhauser

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Below I've pasted an excerpt from 'Podiatry Mangement Online' dated 2003:

"Excision of sesamoids would be included in CPT
28122 allowance. CPT 28315 is designated
as "separate procedure" which means it is only
considered for independent reimbursement when it
is unrelated or distinct from other procedures
being performed; CPT 28315 should not be
reported separately. "

So if that is correct, then your answer is no. Maybe someone else has more recent documentation they can add....
 

mkmgt001

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I just wanted to point out that CCI allows this code combination (CPT 28122 & 28315) & modifier -59 is not required. I couldn't find anything else on this code combination though.

Mary Kittredge, CPC
 
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