Effective January 1, 2024, there will be changes to the definitions/descriptions of the CPT codes for Correction of Hallux Valgus deformities.
Prior to January 1, 2024:
“Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed...”
This pertains to the following CPT codes:
28292 Correction, hallux valgus [bunionectomy], with sesamoidectomy, when performed. with resection of proximal phalangeal base, when performed, any method.
28295 Correction, hallux valgus [bunionectomy], with sesamoidectomy when performed, with proximal metatarsal osteotomy, any method.
28296 Correction, hallux valgus [bunionectomy], with sesamoidectomy, when performed, with distal metatarsal osteotomy, any method.
28297 Correction, hallux valgus [bunionectomy], with sesamoidectomy; when performed, with first metatarsal and medial cuneiform arthrodesis, any method.
28298 Correction, hallux valgus [bunionectomy], with sesamoidectomy, when performed, with proximal phalanx osteotomy, any method.
28299 Correction, hallux valgus [bunionectomy], with sesamoidectomy, when performed, with double osteotomy, any method.
Starting January 1, 2024:
“Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed…”
The new CPT code definitions will be the following:
28292 Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed. with resection of proximal phalangeal base, when performed, any method.
28295 Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed, with proximal metatarsal osteotomy, any method.
28296 Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed, with distal metatarsal osteotomy, any method.
28297 Correction, hallux valgus with bunionectomy, with sesamoidectomy; when performed, with first metatarsal and medial cuneiform arthrodesis, any method.
28298 Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed, with proximal phalanx osteotomy, any method.
28299 Correction, hallux valgus with bunionectomy, with sesamoidectomy, when performed, with double osteotomy, any method.
The bottom line is that in order to bill any of the above CPT codes and support their performance with the proper documentation, a “bunionectomy” needs to be performed in addition to any other corrections/procedures that are stated within the definition of the CPT code. A bunionectomy is the removal or the excision of the medial aspect of the head of the 1st metatarsal. If this is not performed, then it would be inappropriate to bill any of the CPT codes listed and defined above.
This is my opinion.
Michael G. Warshaw
DPM, CPC
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