09/22/2020

Correct Coding for Flatfoot Surgery, Evans Osteotomy and a Posterior Calcaneal Osteotomy

a patient underwent flatfoot surgery and had an Evans osteotomy and a posterior calcaneal osteotomy to correct the deformity in 2 different planes. Is the correct CPT code 28300 twice or only once? I see the MUE is 1 but it is hard to believe the second osteotomy is included in the fee for the first?

Through MUE edits would suggest only one osteotomy per day is common, it would be appropriate to bill CPT code 28300 twice to reflect each procedure. The CPT would be billed as two line items with the appropriate site modifier and modifier -59 appended to the second surgical charge. It is possible that the second charge may be denied as bundled or inclusive due to MUE edits. Op-reports may be needed to justify that two separate incisions were done on the patient and the procedure was done on two separate planes of the foot, which should justify separate reimbursement.