Question Question on amputation

WHAUN

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Provider performed a MPJ amputation along with the proximal 1/3 of the metatarsal - he calls it a 5th ray resection. I'm finding conflicting info on whether I can code this as 28810 - since he did not take the entire metatarsal, I do not think this is appropriate. Would this then be coded as 28820? Any help is appreciated. Here is the bulk of the procedure description:

Attention was directed over the fifth metatarsal on the patient's right foot where a chronic ulceration was noted. A dorsolateral incision was created which ellipsed the ulceration in its course around the base of the fifth digit. This was taken deep to the bone level and dissection was taken through the subcutaneous layers addressing all vital neurovascular structures. The bone was investigated and healthy level was found near the proximal one third of the metatarsal and a beveled resection was performed. The distal metatarsal, metatarsophalangeal joint, and fifth toe was then dissected free from underlying soft tissue attachments and extirpated in total from the surgical site. The bone recontoured using a hand rasp.

Thanks!
 

podcoder70

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28110 used to read "including toe". There are comments on aapc from many years back stating this is the code to use. However, since the code no longer says "including toe" I am not certain as to whether you should add the amputation code as well. I can do some more research on this if you would like. You can reach out to me in a PM.
 
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There is an NCCI edit for 28122 with 28820. I have been using 28810-52 with the appropriate T modifier for amputations of toe at mtpj with metatarsal head resection (partial ray resection).
 
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