Wiki Mcbride and 1st TMT Arthrodesis

[kle0204]

Good morning!

I have attached an op report pertaining to the 1st TMT arthrodesis using the Lapidus system and a Mcbride bunionectomy. I know there's 28297 which combines these two procedures, but I've also been told that this could be coded as 28740 and 28292 if the patient has degenerative joint/instability of the TMT joint and a hallux valgus.

I would really appreciate your inputs.

Thank you so much!

 

[podcoder70]

What was the intent of the procedure? To correct a bunion? 28297 seems like the correct code. Otherwise its unbundling.

 

[amyjph]

Agree, if intent is bunion/hallux valgus you can't unbundle them.

 

[kle0204]

The patient's preoperative diagnoses does include the hallux valgus, but the provider would usually start with the 1st TMT arthrodesis to treat the TMT joint degenerative disease and then notate that the hallux valgus was still an issue so the Mcbride was also done. He states that it's more work than a regular hallux valgus fix, so if the intent was more for the degenerative disease, then would 28740 and 28292 be okay?