Wiki Is this another billable procedure?

[reac2005]

I'm having trouble finding a cpt for this unknown complication causing phys to perform additional service. Please advise of any CPT I can fit.
Patient has L great toe amputation (28820). When provider tried to close he found reaming bone and cartilage was sclerotic. Therefore we was unable to close. He then had to saw some of the remaining first metatarsal bone. Phys was able to close after removing sclerotic cartilage and bone.
Thank you in advance for any advice.

 

[Orthocoderpgu]

I'm going to read into this a bit so if you need to verify, please do. You said that the surgeon used a saw. That tells me that an osteotomy was performed. For that use 28306. Don't use 28288 as that is for osteotomy of the entire head.

 

[reac2005]

Thank you for you advise. That is what I needed.

 

[fwnewbie]

So the physician did the amputation and had to do some extra debridement of the bone/cartilage before closing? Wouldn't that work be included in the amputation?

 

[Orthocoderpgu]

So the physician did the amputation and had to do some extra debridement of the bone/cartilage before closing? Wouldn't that work be included in the amputation?

Per the note debridement was not done. During the amputation process (in this case it's more of a dis-articulation) the physician found unexpected pathology and performed an osteotomy to treat it.

 

[fwnewbie]

Thanks for the clarification. I'd like to know the Dx that made this amputation necessary and if it was due to the pathology they found.