Wiki CPT for bunionectomy with distal soft tissue realignment and stabilization of MTP joi


Campbellsville, KY
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Hey everyone I hope you can help. For the following scenerio the only CPT code I came up with was 28290-TA. Can some of you read the following scenerio and let me know if you think I should use a seperate code for the soft tissue realignment and stabilization of the MTP Joint with a modifier? I feel that I am missing something because a 2nd incision was made but I have researched until I am numb. The dx is Hallux valgus deformity, left great toe 735.0. Any help you can provide will be appreciated. The example is as follows:

"Medial soft tissue release was carried out. A bunionectomy was carried out with an oscillating saw just medial to the articular surface of the first MTP joint. She had a large amount of calcium deposit from her gout on the MTP joint. Medial soft tissue release was carried out with mid fenestration of the capsule and release of the adductor hallicis tendon. The sesamoids were carefully aligned underneath the metatarsal head. The MTP joint was carefully reduced under direct visualization and was stabilized x2 with K-wires, 0.62, drilled in from the medial side of the base of the proximal phalanx. Pins were cut short and bent. The deformity was nicely corrected. A secondary incision was made over the head of the second metatarsal. A mini tight rope suture anchor was then passed from lateral to medial. The IMA angle was held reduced to about 14 degrees. It was tightened down into position with a tightrope suture ankle. Two mini statak suture anchors were then used on the medial aspect of the great toe. These allowed the soft tissues to be mobilized proximally and dorsally to allow for corrective force on the great toe distally. Wound was lavaged with bacitracin irrigating solution. The capsule was carefully repaired, subcuticular sutures were applied. Staples were applied to the skin. Then, 20ml of half percent Marcaine plain was placed locally for postoperative analgesia. No complication encountered. A dressing was applied followed by postoperative shoe."

Annie Blair, CPC-H-A