“I am excising a wound on top of the foot (not on the bottom) and opening up to expose a Brodie abscess of the cuboid. Following this, I will be curetting the abscess from the bone to promote bleeding of the bone and filling it with an allograft bone putty impregnated with antibiotics. I am considering using these following CPT codes 28107 and CPT 15999. Is CPT 15999 correct to use for a wound on top of the foot?"
So, the patient has a Brodie abscess within the cuboid. The abscess was curettaged from the cuboid and the deficit was then filled in with an allograft that was impregnated with antibiotics. The CPT code that was billed is CPT code 28107 which is defined as: Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft. I agree with the use of this CPT code. However, I do have an issue with CPT code 15999 which is defined as: Unlisted procedure, excision pressure ulcer. Aside from the fact that the use of an unlisted CPT code often leads to a dead end with respect to reimbursement, I have another issue.
A wound was excised from the top of the foot in order to EXPOSE the Brodie abscess within the cuboid. Since the wound excision was utilized in order to perform the curettage of the Brodie abscess, wouldn’t the wound excision be considered to be an integral part of the Brodie abscess curettage? Of course it would be. Therefore any CPT code that was used to demonstrate that the wound was excised to provide exposure of the Brodie abscess would not be reimbursable. Thus, with respect to the above posted scenario, the only CPT code that could and should be billed is CPT code 28107.
This is my opinion.
Michael G. Warshaw
DPM, CPC
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