“Can I still bill one of the hallux valgus correction codes if I don’t excise the medial aspect of the head of the 1st metatarsal even if I correct the IM angle?”
Hallux Valgus Correction Codes Prior to 2024:
Each of the 6, hallux valgus correction CPT codes have the same phrase to initiate the definition of the code: “Correction, hallux valgus (bunionectomy), with sesamoidectomy when performed.”
Prior to 1-1-24:
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed…
Starting 1-1-24:
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed…
- The bottom line is that in order to bill 28292, 28295, 28296, 28297, 28298, 28299, the medial aspect of the head of the 1st metatarsal MUST be excised/removed in addition to any additional procedures that are performed to correct the hallux valgus deformity to justify and support the CPT code that is billed.
- Bunionectomy = excision/removal of the medial aspect of the head of the 1st metatarsal
For example: “For first metatarsal-cuneiform joint fusion without concomitant removal of the distal – medial prominence of the first metatarsal for hallux valgus correction, use CPT code 28740” which is defined as the following: Arthrodesis; midtarsal or tarsometatarsal, single joint.
Additional Hallux Valgus Correction Procedure to Consider:
CPT 28750 Arthrodesis, Great Toe; Metatarsophalangeal Joint:
- CPT code 28292 (Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed, with resection of proximal phalangeal base, when performed, any method) and CPT code 28750 (great toe MTP joint arthrodesis/fusion) generally cannot be billed together on the same joint during the same operative session. They represent mutually exclusive or bundled primary procedures for the first metatarsophalangeal (MTP) joint. When the arthrodesis is performed at the 1st MPJ, all excessive, arthritic bone needs to be excised in and around the 1st metatarsal-phalangeal joint including the medial aspect of the heads of the 1st metatarsal. Since the excision/removal of the medial aspect of the 1st metatarsal head is considered to be part of CPT code 28750, CPT code 28292 cannot be billed due to the fact in essence it would have to be performed twice, once for each procedure.
This is my opinion.
Michael G. Warshaw, DPM, CPC
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