CPT

“I have a patient who will undergo a Cartiva implant procedure for hallux limitus/rigidus at the 1st metatarsophalangeal joint. He also has lateral deviation of his hallux on the same foot and an Akin osteotomy will be performed to address this deformity. Should the Akin osteotomy be billed as a separate procedure or is that considered unbundling?”

“We are having difficulty with a denial when combining CPT 28320 and CPT 20680. CPT 20680 is being rejected as unbundling. According to CCI edits, CPT 28320 is a Column 1 code and CPT 20680 is a Column 2 code and they are allowed. The surgeon removed hardware from a prior surgery performed by a different surgeon not associated with the practice then repaired a non-union and applied new fixation. Is the removal of prior hardware actually included in CPT code 28320? If not, what modifier should be used if it is the same incision/surgical site as the non-union repair?”

“Can CPT code 29580 (strapping – Unna’s boot) be used for ICD code M65.871(2) in lieu of CPT code 29540? If not, what is the best ICD 10 code for CPT 29580?”

“I have a patient with a hereditary floating 2nd toe, secondary to joint instability and contracture of the extensor tendon and capsular tissue. I have decided that the most appropriate surgical procedures for the correction of this situation are a V-Y skin-plasty and an extensor tendon lengthening and are coded with CPT code 14040 and CPT code 28234, respectively. However, the ICD code M20.5×2 (Other deformities of toe(s) (acquired), left foot) does not seem to be listed as a potential diagnosis for the above CPT codes. Please help!”