INTERMETATARSAL SPACE NEUROMA EXCISION W/ IMPLANTATION OF NERVE INTO BONE

[vmounce]

A surgeon did an intermetatarsal space excision of neuroma with implantation of nerve into bone. I billed 28080 with 64999(unspecified) and insurance denied this. Someone told me to use 64774 and 64787. I am at a loss. How should this be coded?

Thanks in advance!
Vickie

 

[amyjph]

There is a CPT for implantation of the nerve end (64787) but it's an add on code and the parent can't be 28080. If the procedure was for Morton's neuroma excision the unlisted might be used. In all the times I have seen this we just billed 28080 and moved on. I have made attempts to get the additional implantation covered but never had success with unlisted even when explaining appealing and comparing to 64787. It was decided it wasn't worth the time spent and post bill effort. There may be a CPT assistant about it, I have not looked recently. The AAOS global guide says it's not included in 28080 but the add on/parent thing is the problem.

 

[vmounce]

There is a CPT for implantation of the nerve end (64787) but it's an add on code and the parent can't be 28080. If the procedure was for Morton's neuroma excision the unlisted might be used. In all the times I have seen this we just billed 28080 and moved on. I have made attempts to get the additional implantation covered but never had success with unlisted even when explaining appealing and comparing to 64787. It was decided it wasn't worth the time spent and post bill effort. There may be a CPT assistant about it, I have not looked recently. The AAOS global guide says it's not included in 28080 but the add on/parent thing is the problem.

That is my issue too. I wasn't sure I was doing it right. Thank you for your response!