“Can someone please clarify the postoperative global period for a percutaneous flexor tenotomy for flexible hammertoes? I thought the postop global for CPT 28010 was ten days. I discovered that it is 90 days! Is it really the same as a bunion correction? I performed an in office flexor tenotomy successfully on one foot and now the patient requests correction for the other foot. I understand how a longer global period would discourage so called “serial surgeries” for higher reimbursements for multiple procedures on one foot. But on the opposite foot as well?”
CPT code 28010 is defined as Tenotomy, percutaneous, toe; single tendon. The postoperative global period for CPT code 28010 is indeed 90 days. Yes, it is the same postoperative global period as a bunionectomy, as a midtarsal arthrodesis, as a transmetatarsal amputation, etc. So, a pecutaneous flexor tenotomy was performed on one toe on a specific foot. It would be appropriately coded as CPT 28010 – Tx (Tx = the appropriate Toe Modifier). The 90 day postoperative global period has now been put in motion.
Now the patient requests that a needed percutaneous flexor tenotomy be performed on the other foot. How should this be coded? Well, the correct coding scenario would be CPT 28010 – Tx. But, wait! We are within a 90 day postoperative global period. Based upon the fact that the second percutaneous flexor tenotomy was clearly not related to the first percutaneous tenotomy, an additional modifier needs to be appended to surgical procedure #2 to demonstrate that the two procedures are NOT related. The modifier in question is 79, which is defined as: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period. The correct coding scenario is now CPT 28010-Tx, 79.
This is my opinion.
Michael G. Warshaw
DPM, CPC
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