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It is possible that when the 59 modifier was appended to CPT code 28285 in the above post designating 28285 as a Distinct Procedural Service, placing it above and beyond CPT code 28308, it allowed for the reimbursement of CPT code 28285 and the rejection of CPT code 28308. Just a thought.
However, when the CCI edits are accessed, CPT code 28285 is not a Column 2 code to CPT code 28308, nor is CPT code 28308 a Column 2 code to CPT code 28285. In other words, these two CPT codes are not bundled within the CCI edits. Therefore, a 59 modifier should not be part of the coding scenario.
“I have great difficulty getting paid for CPT 28308 when a hammer toe repair is performed at the same time. The billing scenario generally will look like this: CPT 28308 (2nd metatarsal osteotomy) -RT CPT 28285 (2nd hammertoe repair) -T1 -59 We never get paid for CPT 28308 in this scenario. Does anyone have any suggestions? We link the acquired deformity of bone diagnosis to CPT 28308.”
The Weil osteotomy is done for plantar plate deficient MTP joints Some surgeons consider adding a flexor tendon transfer to the procedure. Combined Plantar Plate Repair And Weil Osteotomy you probably should use an unlisted code. The dorsal approach for anatomic plantar plate repair provides a combined alternative to fully correct the complex nature of both a plantar plate repair and metatarsal deformity. The dorsal approach of this procedure allows the surgeon appreciation of both severe and subtler plantar plate injuries that may not be clearly evident from a plantar approach. This approach also allows for metatarsal realignment and prevention of a plantar scar
What is procedure code 28308?
What is procedure code 28285?
Does CPT 28285 need a modifier?