“What is the proper CPT code for percutaneous capsulotomy and tenotomy of metatarsophalangeal joint?”
So, a percutaneous capsulotomy and tenotomy were performed at the metatarsophalangeal joint. What would be the most appropriate way to bill this scenario?
There is not a CPT code for a percutaneous capsulotomy of a metatarsophalangeal joint. Whether the capsulotomy is performed percutaneously or performed in a traditional fashion, the correct CPT code to bill is CPT 28270 which is defined as the following: Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure).
A percutaneous tenotomy was performed at the same anatomical site as the capsulotomy, the metatarsophalangeal joint. A percutaneous tenotomy is billed with CPT 28010. This is defined as the following: Tenotomy, percutaneous, toe single tendon. When the NCCI edits are accessed, CPT 28010 is not a Column 2 code to CPT 28270, the Column 1 code. Therefore, the two CPT codes are not bundled together.
Does that mean that it is appropriate to bill both of these CPT codes? Even though the two CPT codes are not bundled within the NCCI edits, it would not be appropriate to bill both of these two CPT codes based upon the fact that the anatomical location is the same and clearly the two procedures are directly related. The only CPT code that should be billed is CPT 28270 appended by the correct anatomical modifier, RT or LT.
This is my opinion.
Michael G. Warshaw
DPM, CPC
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