Wiki Tailor's Bunion 5th Toe (Reverse Austin)

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Joyce Burchett

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Op Report: 4 cm linear incision placed over 5th MPJ. Dissection carried down to level of joint capsule where a T capsulotomy was performed. All periosteal as well as capsular tissues were dissected free from the head of the 5th MPJ. Using a high speed oscillated saw the lateral eminence removed. A tempered K-wire was inserted at the apex of the future osteotomy site. The osteotomy was then cut. The capital fragment was translocated medially about 1/3rd of the width of the metatarsal shaft. A 1.5 x 16mm screw was placed across the osteotomy site going from the dorsal distal to the plantar proximal direction & tightened to two-finger tightness. Remaining lateral eminence was transected with high speed saw. A 3-0 vicryl was used to reapproximate the capsule, 4-0 subcu, 5-0 for skin edges. Isn't CPT 28296 for big toe bunionectomy only? I thought this should be coded 28110 or 28308. I have done extensive research & could not find a "reverse austin bunionectomy" for 5th toe. Any help or explanation would be helpful.
 
I would try for Reverse Austin cpt 28296 Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)

( You should also use this code to report Reverdin-Green osteotomy, Reverse Austin, Mitchell, Chevron, Kalish, Youngswick, Reverdin, Hohmann, and LaGreshino bunionectomy procedures.)

I was having a hard time locating reverse austin bunionectomy as well but stumbled on this that is in () above

This code also includes the metatarsal osteotomy 5th Toe :p

Hope this helps
 
It looks like a true osteotomy was performed on a tailor's bunion, 28308, osteotomy, lesser metatarsal would be appropriate. If a complete resection of the 5th met head was performed then 28113 would be more appropriate, however, that is not what is documented.
 
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