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ORIF Tarsometatarsal FX

  1. Default ORIF Tarsometatarsal FX
    Medical Coding Books
    Doc did ORIF of 1st, 2nd, 3rd and 4th tarsometatarsal fracture (Lisfranc). Would you choose 28485? If so would you charge it once and then 3 X with modifier 59?

  2. #2
    Default ORIF Tarsometatarsal FX
    28485 is the correct code--If the patient is MCR..then you will bill RT/LT with modifier 59...but if commercial insurance you will use the modifiers TA-T2 or T5-T7 not modifier 59.
    Ex: 28485 TA
    28485 T1/51
    28485 T2/51

    28485 LT
    28485 59/LT
    28485 59/LT
    *I would put in procedure comments stating the specific MTL if MCR

    Hope this helps!

  3. #3
    I thought you could only use the T-modifiers on the phalanges and not on TMT's?

  4. #4
    I actually didn't know that--but I did just read a publication, you are correct. I'm sorry...the publication states to use LT or RT. So I would code by line item and use the modifier 59.

    The proper use of modifiers is very important. Start with the T modifiers to identify a surgery performed on specific toes. T modifiers only apply to the phalanges distal to the metatarsophalangeal joint. Do not use T codes to identify metatarsal work. For metatarsal and more proximal work, one should also use RT and LT modifiers whenever possible. If those two are not appropriate, use the -59 modifier.

  5. #5
    ORIF Tarsometatarsal joint dislocation is 28615 and can be charged for each.

  6. Default
    28615 is for dislocation, not fracture though.

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