Wiki How do you code an Evans procedure - cuboid osteotomy?

Messages
1
Location
Rushville, IN
Best answers
0
The surgeon did a hardware removal (20680) and a Calcaneal osteotomy (28300) before turning his attention to the following:

"Evans procedure - cuboid osteotomy: attention was then directed to the lateral aspect of the left foot. The bony landmarks for the cuboid bone were identified and a 3 cm linear longitudinal incision was made directly over the cuboid bone. Dissection was taken down to the periosteum and any bleeders were either cauterized or ligated as necessary. The cuboid bone was bisected vertically and a reciprocating sagittal saw was used to make the osteotomy. The Evans wedge sizers were then used. The appropriate sizer was a 10mm wedge which gave great lateral correction of his foot deformity. A 10 mm bone wedge was then placed in the osteotomy site and anchored with a 3 hole plate and 2 2.7 screws. The wound was irrigated with sterile saline and the subcutaneous tissue was closed wit 2 0 Vicryl. The skin was then surgically stapled."

I am having trouble coding this one because the description for the cuboid osteotomy (28304) does not mention anything about adding the wedge and fixation. The Evans procedure (28260) talks about releasing joints and lengthening tendons which is not in the documentation.

I am strongly leaning towards 28304, but what about the wedge placement and fixation? I have seen in other forums talk about coding a second 28300, but that is calcaneal and this specifies that it was the cuboid.

Help would be greatly appreciated.
Thank you in advance!
 
I think you're on the right track. I agree that 28260 and 28300 do not appear to be appropriate for what was done. It seems to be closest to either 28304 or 28305. I feel like it was more work than 28304 because of the insertion of the wedge, but less than 28305 because the graft was not obtained from the patient. I'd probably stick with the 28304 and assume the allograft is included.
 
Top