Question Percutaneous pinning of Hammertoe

jdibble

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I am not sure how to code this procedure and hopefully someone can help!

Preoperative Diagnosis
Hammertoe deformities bilateral feet in the 2nd, 3rd, 4th, and 5th toes

Procedure Performed
Closed reduction and pinning of the bilateral 2nd, 3rd, 4th toes

Indications
Patient with rigid claw toe deformities lesser toes of both feet. She has difficulty with shoe wear due to pressure due to the deformities. She has failed conservative treatments. She is elderly and poor surgical candidate. She has had multiple previous surgeries that have resulted in MRSA infections. I have discussed with her the were going to do minimal necessary to correct the toe deformities. I plan to avoid incisions if at all possible

Technique/Description of Procedure
After informed consent was obtained, patient was taken to the operating room where general anesthetic was introduced. Previous popliteal blocks were placed in the recovery room. The left 2nd toe was close reduced with traction and plantar applied force. The toe straightened. A 0.45 mm K-wire was then placed through the end of the toe across the DIP PIP and MCP joints to hold the toe in a reduced straight position. C-arm confirmed the pin placement. The identical procedure was then performed on the left 3rd toe, left 4th toe, right 2nd toe, right 3rd toe, right 4th toe. Pin caps were placed on the ends of the pins. Patient was woken taken recovery room in satisfactory condition

I am not sure which code I would use for this procedure, then how would I code it for it done bilaterally on 6 toes.

Thank you for all help!
Jodi
 
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To the best of my knowledge, and I'm in no way an Ortho expert but I've coded a lot of hammertoes, hammer toe/claw toe corrections are coded with 28285 regardless of how it was done. I couldn't find a whole Coding Clinic on this for you but they do state (in different places of course): "CPT code 28285, Correction, hammertoe, is appropriately reported for all hammertoe corrections." & "[...] the insertion of K-wire through DIP, PIP, and MTP joints are all inclusive components of the procedure described by code 28285, Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)."

So.

If this were me and my case, I would code this as 28285-T1, 28285-T2, 28285-T3, 28285-T6, 28285-T7, 28285-T8.
 

jdibble

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To the best of my knowledge, and I'm in no way an Ortho expert but I've coded a lot of hammertoes, hammer toe/claw toe corrections are coded with 28285 regardless of how it was done. I couldn't find a whole Coding Clinic on this for you but they do state (in different places of course): "CPT code 28285, Correction, hammertoe, is appropriately reported for all hammertoe corrections." & "[...] the insertion of K-wire through DIP, PIP, and MTP joints are all inclusive components of the procedure described by code 28285, Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)."

So.

If this were me and my case, I would code this as 28285-T1, 28285-T2, 28285-T3, 28285-T6, 28285-T7, 28285-T8.
Thank you so much Ashley. That makes sense and if it is for all corrections than I will use that code!
 
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