shaylaxp
New
Hi, I need help on this coding scenario. I was queried on not billing for the flexor tenotomy being done at the same time for a hammertoe repair. I billed cpt 28285 and did not pick up cpt 28232 as they hit an edit. My coding auditor is stating cpt 28232 is billable since this was done at a different site and through separate incisions from the hammertoe repair and that only extensor work is included in 28285. I however disagree because my surgeon states doing the flexor tenotomy at the head of the proximal phalanx which is closer the distal phalanx where hammertoe correction is usually done at. There is an old cpt assist article from March 2015 that states flexor tenotomy done through separate incisions at the DIP is included in 28285. I'm including the op note to get insight on this from other coders. I think this is over coding but could be overthinking it.
Next, attention directed to the left 5th digit where a flexible hammertoe deformity was identified. The proximal phalanx head was found to be quite prominent laterally. Stab incision flexor tenotomy was performed. Deformity improved after this procedure. Bony prominence were made dorsal lateral aspect of the proximal interphalangeal joint.. An incision was made over the dorsal aspect of the proximal interphalangeal joint. Sharp and blunt dissection used to expose long extensor tendon at the proximal interphalangeal joint. A transverse tenotomy was performed and the head of the proximal phalanx was freed of all soft tissue attachments. A sagittal saw was used to resect roughly 5 mm of bone. Simulated weight bearing was performed and deformity was found to be reduced. The area was irrigated with sterile saline. Extensor tendon then repaired with 4-0 vicryl
Next, attention directed to the left 5th digit where a flexible hammertoe deformity was identified. The proximal phalanx head was found to be quite prominent laterally. Stab incision flexor tenotomy was performed. Deformity improved after this procedure. Bony prominence were made dorsal lateral aspect of the proximal interphalangeal joint.. An incision was made over the dorsal aspect of the proximal interphalangeal joint. Sharp and blunt dissection used to expose long extensor tendon at the proximal interphalangeal joint. A transverse tenotomy was performed and the head of the proximal phalanx was freed of all soft tissue attachments. A sagittal saw was used to resect roughly 5 mm of bone. Simulated weight bearing was performed and deformity was found to be reduced. The area was irrigated with sterile saline. Extensor tendon then repaired with 4-0 vicryl