Wiki Hallux limitus correction w/ implant.

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Kevinph84

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Hello Everyone,

I was wondering if I could get some advice on coding a Hallux limitus correction with osteotomy/ resection with implant (screws/ pinning). I have done some research and seem to come across two possibilities.

First, is to resort to CPT 28899 which is an unlisted procedure code. My issue with this code, is that according to my encoder, ASCs are not allowed to bill for these services.

Second, is to use code 28293. My problem with this one is within the code description is states "Hallux Valgus (Bunion). The condition being treated in not a bunion.

Could someone please offer some guidance on this situation? If there are any resources to utilize, that would be great too! Thank you.

Respectfully Yours,

Kevin P. Honig, CPC
 
I agree with your second choice. Even though it is not a bunion, hallux limitus is in the diagnositic range that covers procedure 28293. Dx code 735.8 is an acceptable dx for this procedure.
 
Just wanting to make a comment in regards to the Encoder program that ASC's are not allowed to bill for these services for 28899. You have to remember that the Encoder program is based on Medicare guidelines and they do not pay (normally that I know of) unlisted CPT codes that have the 99 at the end of them. That doesn't mean that other carriers will not pay. Most of the time I submit those on paper and send documentation with it to support the reasoning for the unlisted code. Any thoughts from anyone else about this??

Susan, CPC-H
 
I agree with pcheshier that 28293 with with dx of 735.8. This is how we would bill the procedure at the office.
 
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