coding help please? multiple procedures

solocoder

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Marshfield, MO
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Trying this one again in a different forum, maybe I'll have better luck?

Does anyone have any advice regarding the best way to code a procedure that includes Lapidus (28297), Austin (28296) and Akin (28298) bunionectomies? Here are the possibilities I am considering:

Option 1 28299 for the Austin/Akin AND 28297 for the Lapidus (too much to hope for?)
Option 2 28299 (for double osteotomy) + 28310-59 for the phalanx osteotomy (again, probably too much to hope for)
Option 3 28297 + 28310-59 which I have been able to get paid in the past, but leaves out any reimbursement for the Austin.

It's Coventry, if that helps any.

Appreciate any suggestions. THANKS.
 

cgaston

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Clarence, NY
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I don't think you can bill for 3 bunion procedures on the same metatarsal. If they are all done on the same joint the NCCI Edits show that 28296 and 28298 are inclusive to 28297 so you would only bill for 28297.
 
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