Monday, January 6, 2014

Unlisted’ best for hallux limitus and arthroplasty

Question: Our podiatrist performed a joint replacement for hallux limitus and thinks we should report 28293. I disagree because the patient does not have a bunion. How should we code this procedure?

Virginia Subscriber
Answer: CPT does not include a code for hallux arthroplasty with implant, so it's time to turn to unlisted codes.


Your best option is to report 28899 (Unlisted procedure, foot or toes). When you determine a comparison code for the most accurate reimbursement, compare the unlisted code 28899 to 28289 (Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint) or 28293 (Correction, hallux valgus [bunion], with or without sesamoidectomy; resection of joint with implant) when submitting your claim.

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