Podiatry Code Changes For 2017

Podiatrists

Wanted to update you with the 2017 CPT Podiatry code changes in case you have not seen them (see below). The 3^rd column provides the rationale for the changes. Remember, don’t shoot the messenger! For clients for whom we support their Charge Form, we will load the updated form on Friday afternoon (tomorrow) so it is ready for Tuesday’s patients.

We have added the New CPT codes for all Podiatry clients and updated the “Description” for the Revised codes. The deleted codes have been set to become “Inactive” after 12/31/16.

If you have any questions, please call Rich.

1. New CPT codes:

28291	Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant	Code 28291 was added to provide a code to report hallux rigidus correction with implant; a code (28289) already existed for hallux rigidus correction without implant.
28295	Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method	Code 28295 was added to provide a way to report correction of hallux valgus (bunion) with sesamoidectomy and removal of the base of the proximal phalanx (first toe bone), when performed; the existing bunionectomy codes specify "with or without" sesamoidectomy.

2.Deleted codes: Bunionectomy codes 28290, 28293 & 28294 have been deleted effective 12/31/16.

3.Revised codes: 28289, 28292, 28296, 28297, 28298, & 28299 – plus 77002.

28289

Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint

Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant

CPT® 2017 revised the official descriptor for 28289, which describes the correction of arthritis and deformity of the joint where the head of the metatarsal bone attaches to the first bone of the greater toe, by clarifying that this code is for correction of the condition without an implant.

The code set makes other revisions to this family of codes with the addition of new procedure 28291 (Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant) to report this service when an implant is necessary to correct the deformity. 28295 is also added to report this service when a proximal metatarsal osteotomy is necessary to correct the deformity.

Additional changes to the code set include revisions to descriptors for 28289, and 28292 to 28299 and deletion of procedures 28290, 28293, and 28294 to remove legacy named procedures and to more accurately describe the services as they are currently performed. We recommend careful review all the codes in the range before choosing your final code for bunion correction.

28292

Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure

Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with resection of proximal phalanx base, when performed, any method

CPT® 2017 revised the official descriptor for 28292, which describes the correction of a bunion, to identify that the service is reported for a bunion correction including removal of a sesamoid bone or a resection of proximal phalanx base, when necessary. The removal of the sesamoid bone or removal of part of the articulating end of the bone in the foot, closest to where it attaches, is done to realign the metatarsal bone and help the toe lie straight.

The code set makes other revisions to this family of codes with the addition of new code 28295 to report this service when a proximal metatarsal osteotomy is necessary to correct the deformity. A proximal metatarsal osteotomy is done to reduce the angle between the first and second metatarsal by incising the first metatarsal near the base of the bone and then rotating or moving the bone to achieve a reduction in the angle. There are several types of proximal metatarsal osteotomies.

Additional changes to bunionectomy procedures include revisions to descriptors for 28289, and 28292 to 28299 and deletion of procedures 28290, 28293, and 28294 to remove legacy named procedures and to more accurately describe the services as they are currently performed. We recommend careful review all the codes in the range before choosing your final code for bunion correction.

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28296	Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)	Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with distal metatarsal osteotomy, any method	CPT® 2017 revised the official descriptor for 28296, which describes the correction of a bunion, to identify that the service is reported for a bunion correction, with a distal metatarsal osteotomy, where a small wedge of bone is removed from the toe’s point of attachment. The procedure may also include removal of a sesamoid bone, when necessary, to help with realignment of the metatarsal bone. The code set makes other revisions to this family of codes with the addition of new code 28295 to report this service when a proximal metatarsal osteotomy is necessary to correct the deformity. A proximal metatarsal osteotomy is done to reduce the angle between the first and second metatarsal by incising the first metatarsal near the base of the bone and then rotating or moving the bone to achieve a reduction in the angle. There are several types of proximal metatarsal osteotomies. Additional changes to bunionectomy procedures include revisions to descriptors for 28289, and 28292 to 28299 and deletion of procedures 28290, 28293, and 28294 to remove legacy named procedures and to more accurately describe the services as they are currently performed. We recommend careful review all the codes in the range before choosing your final code for bunion correction.
28297	Correction, hallux valgus (bunion), with or without sesamoidectomy; Lapidus-type procedure	Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method	CPT® 2017 revised the official descriptor for 28297, which describes the correction of a bunion, to identify that the service is reported for a bunion correction which includes fusion of the joint between the bone in the foot just behind the big toe and the bone of the middle foot located behind the first metatarsal. This fusion may be done along with removal of a sesamoid bone, when necessary, to help reduce the angle between the first and second metatarsal. The code set makes other revisions to this family of codes with the addition of new code 28295 to report this service when a proximal metatarsal osteotomy is necessary to correct the deformity. A proximal metatarsal osteotomy is done to reduce the angle between the first and second metatarsal by incising the first metatarsal near the base of the bone and then rotating or moving the bone to achieve a reduction in the angle. There are several types of proximal metatarsal osteotomies. Additional changes to bunionectomy procedures include revisions to descriptors for 28289, and 28292 to 28299 and deletion of procedures 28290, 28293, and 28294 to remove legacy named procedures and to more accurately describe the services as they are currently performed. We recommend careful review all the codes in the range before choosing your final code for bunion correction.
28298	Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx osteotomy	Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal phalanx osteotomy, any method	CPT® 2017 revised the official descriptor for 28298, which describes the correction of a bunion; to identify the service is reported for a bunion correction which includes a proximal phalanx osteotomy where the provider removes bone at the base of the big toe to help straighten the toe. This procedure may be done along with removal of a sesamoid bone, when necessary, to help with realignment of the bone. The code set makes other revisions to this family of codes with the addition of new code 28295 to report this service when a proximal metatarsal osteotomy is necessary to correct the deformity. A proximal metatarsal osteotomy is done to reduce the angle between the first and second metatarsal by incising the first metatarsal near the base of the bone and then rotating or moving the bone to achieve a reduction in the angle. There are several types of proximal metatarsal osteotomies. Additional changes to bunionectomy procedures include revisions to descriptors for 28289, and 28292 to 28299 and deletion of procedures 28290, 28293, and 28294 to remove legacy named procedures and to more accurately describe the services as they are currently performed. We recommend careful review all the codes in the range before choosing your final code for bunion correction.
28299	Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy	Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with double osteotomy, any method	CPT® 2017 revised the official descriptor for 28299, which describes the correction of a bunion; to identify the service is for a bunion correction when two osteotomy procedures are necessary to straighten the toe. These procedures may be done along with removal of a sesamoid bone, when necessary, to help with realignment. The code set makes other revisions to this family of codes with the addition of new code 28295 to report this service when a proximal metatarsal osteotomy is necessary to correct the deformity. A proximal metatarsal osteotomy is done to reduce the angle between the first and second metatarsal by incising the first metatarsal near the base of the bone and then rotating or moving the bone to achieve a reduction in the angle. There are several types of proximal metatarsal osteotomies. Additional changes to bunionectomy procedures include revisions to descriptors for 28289, and 28292 to 28299 and deletion of procedures 28290, 28293, and 28294 to remove legacy named procedures and to more accurately describe the services as they are currently performed. We recommend careful review all the codes in the range before choosing your final code for bunion correction.
77002	Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device)	Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)	CPT® 2017 revised the official descriptor for 77002, which describes fluoroscopic guided needle placement, along with 77003 for fluoroscopic guidance for spine or paraspinous injection procedures, by designating them as add-on codes. CPT® revises the descriptors to include the parenthetical note (List separately in addition to code for primary procedure) and revises the global periods for both codes to reflect an add-on code; global value ZZZ. Additional modifications were made to the instructions and vignettes for each code in the CPT® manual.