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Bunionectomy & excision of bone spur

  1. Question Bunionectomy & excision of bone spur
    Medical Coding Books
    I need help; surgeon does a Youngswick bunionectomy with internal screw fixation/left foot & excision of bone spur/left hallux: The op note is pretty lengthy if needed please let me know. I was looking at 28296 for the bunionectomy & confused on the excision of the bone spur looking at 28108 but have questions and need help/direction.

    I see that 28108 is bundled in 28296 but checked the CCI edits & it is allowed with a modifier. Can I code both CPTS if the bunion is from the 1st mtp joint & the bone spur excised from the proximal phalanx of the left hallux, seperate site/seperate incisions? Does this not meet the criteria for modifier 59? I checked out a bulletin from the AAOS August 2002 which states under 28296 "removal of additional exostoses in the area of the joint is inclusive." I'm so confused.

    Any help/direction would be appreciated. Thank you in advance for your help.

    Jody Hecht

  2. #2
    All bunionectomies includes sesamoidectomy and/or simple exostectomy as part of the procedure. I would only code the exostectomy only if the operative proves that the exostectomy was more invovled than a simple exostectomy. I would only use 28108 only if the doctor documented a bone cyst not a bone spur.
    Tammy Hulsey-Ferguson, CPC
    Past President AAPC Wichita, KS Local Chapter

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