Wiki Hammertoe Correction

[lkross]

Hello,

I recently attended a conference in which they told us that multiple procedures performed on a single digit are usually considered a hammertoe correction and are only payable to the 28285 code.

If the Doctor performs a hammertoe correction (28285) with a diagnosis of 735.4 on 2R and then performs an open tenotomy/capsulotomy (28270) with a diagnosis of 718.47 and 727.81 on the 2R MPJ, can both of these codes be billed or should we only be billing 28285?

Thank you!

 

[player14]

These aren't column 1/column 2 codes; there isn't a CCI edit for these codes being billed together as the 28285 is done via IPJ and 28270 on MPJ. I would also check with the payer policy. See this site below for more info.

http://www.aaos.org/news/aaosnow/may11/managing1.asp

Hammertoe repair and capsulotomy
Question: Does a hammertoe repair include a capsulotomy?

Answer: To answer this question, the location of the capsulotomy must be identified. A capsulotomy of the interphalangeal joint (CPT code 28272) is included in a hammertoe repair (CPT code 28285) performed on the same toe. A metatarsophalangeal joint capsulotomy for a joint contracture (CPT code 28270) is not inclusive to 28285, because the capsulotomy is performed on a different joint than the hammertoe repair.