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Revision Bunionectomy

  1. Default Revision Bunionectomy
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    My surgeon did double ostectomies (28299) on a patient who had a prior bunionectomy on the same foot. Patient is out of post op period. I am wondering if there is a revision code for bunionectomy? Op note does fully describe 28299 so I don't think an unlisted would be appropriate. I am also hung up on the dx for this. Surgeon already corrected the bunion deformity with the prior surgery so I don't think bunion dx would be correct. Nor do I think it could be considered a fracture. Surgeon states patient went running a little too soon resulting in derangement of prior correction. I am thinking V54.89 and/or possibly V15.81.
    Thank you in advance for any assistance.


  2. #2
    I would use the appropriate dislocation code according to location (e.g. metatarsal bone closed 838.04) and V15.81 noncompliance of medical procedure with CPT 28645 open treatment of metatarsophangel joint or other open procedure for treating dislocation according to location. Now if the bone had started to calcify then it is a fracture diagnosis with diagnosis of 825.25 closed fracture of metatarsal bone and V15.81 pt noncompliance with CPT of 28485 open treatment of metatarsal fracture, includes internal fixation, with perform, each. You will need to include accident information of accident date with description of patient fracture foot due to running. Also will need a 79 modifier since the dislocation or fracture treatment is due to injury and noncompliance of the patient is different diagnosis from original procedure.
    Tammy Hulsey-Ferguson, CPC
    Past President AAPC Wichita, KS Local Chapter

  3. Smile
    Thanks! I appreciate your help. Hopefully feet wont be so confusing to me for too much longer.

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