Tarsometatarsal Fusion with Bunionectomy (28740 & 28292)

k4lilly

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Hi,

I have found three threads on here relating to this, but for the most part they are regarding fusion of the 1st metatarsal cuneiform joint with the bunion repair, which I understand is indeed included in the bunion repair.

I have read a few reports on how tarsometatarsal joint fusion can indeed be billed separately if it is for a separate issue. (hypermobile joint, arthritis) But, they are not from a reputable site. And I have also seen someone quote modifier 59 as stating that a separate diagnosis is not appropriate use of modifier 59.

Is there any documentation out there that specifically states that you cannot bill fusion of the TMT joint (28740) with 28292 and not just fusion of the 1st metatarsal cuneiform?

My providers strongly feel that this is the case, that TMT is separate.

Thank you,
Kelly Lilly
 
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