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Wiki Subtalar joint infusion with osteotomies

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rgrimes

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Provider did a subtalar joint fusion with rigid internal fixation, a medial calcaneal displacement osteotomy with rigid internal fixation and an Achilles tendon lengthening and a cotton osteotomy all on the same foot.
Codes given are 28725, 28300, 28304, 27685
The insurance is stating that 28300, 28304, 27685 are all included in 28725 but it seems that it is additional work involved. What recommendation would you have to support billing those in addition to 28725 (modifier 59 was already added).
Thank you.
Ruth Ann
 
Subtalar joint fusion is 28725. The 28300 and 283044 would be included as they have NCCI edit coding pairs. The 27685 has no coding pair with 28725 and and therefore, 28725 should be coded with the 59 modifier.
 
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