Metatarsal exostosis excision

[coder067]

I think the code should be 28122 but i'm getting another opinion that it should be coded 28104 that it is a bone cyst. Does anyone have anything in writing saying what it should be coded has?

Thanks

 

[dclark7]

I usually look for similar examples in the CPT book. If you look at the Leg and Ankle Joint section of CPT there is a note that tells you "for exotosis excision use 27635". If you look at code 27635 the description is "Excision or curettage of of bone cyst or benign tumor, tibia or fibula." So I would look for a similar description for the metatarsal exotosis excision which would lead to code 28104.

Looking at the descriptions for 28104 compared to 28122 I think a case could be made for either one, but I'd still go with 28104 based on the note for 27635.

 

[nsteinhauser]

Look under the podiatry thread for 04/19/12 "exostosis confusion..." Jamie queried the AMA and they responded that 'an exostosis is a benign tumor'..... so it would be 28104. Seems odd, I know, but there it is.

 

[coder067]

Thanks for your help! It does seem weird.