Bunionectomy

“I have a patient who had a chevron bunionectomy 10 years ago. The bunion has returned and the head is facing lateral. My plan is to perform a Lapidus procedure to reduce the first intermetatarsal angle and a rotational 1st metatarsal head osteotomy to align the articular surface (basically an Austin with a medial based wedge removed from the dorsal osteotomy to rotate the head slightly medial). How would you recommend I code this (ICD-10 and CPT codes)? Can I use CPT 29297 and CPT 29296? I’ve also considered CPT 28740 with CPT 29296. Thanks.”

“I have a patient who had a bunionectomy. The patient was diagnosed with a post- operative infection within the global period which required evaluation and management. I billed Medicare for an office visit, but Medicare will not pay. What am I doing wrong? I used 24 as a modifier.”

“I know things have changed a little for removal of retained hardware and I am seeking clarification for a scenario. A patient has previously had an Austin Akin bunionectomy. It healed uneventfully. Years later, she has developed pain at the retained screw in the metatarsal. There is a k-wire noted in the proximal phalanx. X-rays showed complete healing at the osteotomies. The patient would like to have both implants removed despite only one of them hurting today. How would the changes in CPT coding apply to this situation? Thank you for the help.”

Effective January 1, 2024, there will be changes to the definitions/descriptions of the CPT codes for Correction of Hallux Valgus deformities.