On December 11, 2024, I will be presenting a webinar entitled “Step Up Foot and Ankle Coding.” As part of the promotion of the webinar, one of the topics addressed was hallux valgus correction and the following statement was made:
“New Bunionectomy CPT Language: CPT codes 28292, 28295, 28296, 28297, 28298, 28299
Prior to 1-1-2024: Correction, hallux valgus [bunionectomy], with sesamoidectomy, when performed…
Effective 1-1-2024: Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed…
The bottom line is that in order to bill CPT codes 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.”
In response to the above post, the following statement was made by N.C.:
“The below statement is incorrect- you can perform and MIS bunion and never touch the medial head and bill a 28296 or 28299
The bottom line is that in order to bill CPT codes 28292, 28295, 28296, 28297, 28298, 28299, the medial aspect of the head of the 1st metatarsal MUST be excised.”
My response to the above statement is WRONG! Now for the hard copy proof.
Prior to January 1, 2024, the descriptions of CPT codes 28292 – 28299 were the following:
- • 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
As of January 1, 2024, there was a significant CPT change made regarding the above CPT codes:
New Bunionectomy CPT® Language
Prior to 1-1-24:
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed…
Effective 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.
Since CPT has made the changes as stated above, in order to bill the above CPT codes, the procedures performed need to be identified by the CPT codes that are billed.
End of story.
This is not my opinion. These are the rules.
Michael G. Warshaw, DPM, CPC
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