10/31/2018

Proper Billing for Second Metatarsal Head Joint Replacement.

Doing a second metatarsal head joint replacement. What CPT code do I use

After reviewing the information provided and our discussion, I would suggest billing only 28291 (Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant).

However, since the hallux surgery codes that deal with implants in the CPT definition do not have a valid code to specify the lesser MPJs, (even though they should be billed with T Modifiers) it seemed that billing a specified code for the Metatarsectomy and an unlisted CPT for the implant seemed logical.

• For the removal of the second MPJ head, CPT 28140 (Metatarsectomy) should be billed
• For the insertion of the replacement joint of the second MPJ, the unlisted code 28899 should be billed