The metatarsophalangeal (MTP) joint is located in the 1st through 5th toes, between the base of a proximal phalanx and the head of a metatarsal. The distal interphalangeal (DIP) joint is located in the 2nd through 5th toes, between the base of a distal phalanx and the head of a middle phalanx. The interphalangeal (IP) joint is located in the great toe, between the base of the distal phalanx and the head of the proximal phalanx (Note: There is no middle phalanx in the great toe/hallux/first toe). 28153 Resection, condyle(s), distal end of phalanx, each toe.28126 Resection, partial or complete, phalangeal base, each toe.28111 Ostectomy, complete excision first metatarsal head.
#CPT ORIF 5TH METATARSAL FRACTURE CODE#
Įach phalanx, metatarsal and tarsal bone consists of 3 anatomical sections:īe careful when assigning podiatry CPT codes, as some of the code descriptions specifically reference the bone anatomical landmark, such as: If a patient undergoes a right foot calcaneal osteotomy, assign CPT code 28300-RT. For example, if a patient undergoes a right foot navicular bone osteotomy, assign CPT code 28304-RT (Osteotomy, tarsal bones, other than calcaneus or talus). The distal row consists of the medial cuneiform, intermediate cuneiform, lateral cuneiform, cuboid and navicular bone the proximal row consists of the talus (located at the ankle) and calcaneus (heel bone).īe careful when assigning codes for tarsal surgery, as some of the CPT codes include or exclude specific tarsal bones. There are 7 bones of the hindfoot, arranged in 2 rows. For example, if a patient has a "right 5th metatarsal head exostectomy" performed, assign CPT code 28288-RT (Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head - right side). Metatarsal bones are foot bones, they are not toe bones/phalanges. There are 5 bones called metatarsals located between the proximal phalanges and the distal row of tarsal bones in the hindfoot: 1st, 2nd, 3rd, 4th and 5th metatarsals.ĭon't append toe modifiers (-TA through -T9) to CPT codes that classify metatarsal surgery. For example, if a patient has a right hallux proximal phalanx osteotomy performed, assign code 28310-T5. Code such a procedure as CPT code 28150-T2 (Phalangectomy, toe, each toe - left foot, 3rd digit).Ĭonfirm that the OR report documentation supports the specific phalanx when it impacts the CPT code assignment. For example, if a physician dictates that the "distal phalanx of the left 3rd phalanx was removed entirely," this means that the distal phalanx bone was removed from the left 3rd toe. Some physicians refer to an entire toe as a "phalanx," so be careful when reading the operative reports to distinguish between an entire toe and 1 of the toe bones when "phalanx" is referenced. The 2nd, 3rd, 4th, and 5th toes each have 3 phalanges: proximal phalanx, middle phalanx and distal phalanx. The 1st toe (also called great toe or hallux) has a proximal phalanx and a distal phalanx. There are 14 bones called phalanges located in the toes of a foot. If, however, the contracted toe is a clawtoe, the appropriate code may be 28313. If a contracted toe is actually a hammertoe, the coder will likely assign code 28285. Many surgeons list "contracted toe" as the patient's diagnosis, a problem if a more specific diagnosis is more appropriate, such as hammertoe, clawtoe or joint contracture. 27698: Repair, secondary, disrupted ligament, ankle, collateral (e.g., Watson-Jones procedure).27696: Repair, primary, disrupted ligament, ankle both collateral ligaments.27695: Repair, primary, disrupted ligament, ankle collateral.This information is vital because of these coding descriptions: Many surgeons don't specify ankle ligament repairs as primary or secondary. Here are 2 common documentation deficiencies: To properly assign CPT codes to podiatry cases, coding specialists must first understand the anatomy of the foot, because many of the CPT codes specify the anatomical location of the foot in the code description.Ī coder's knowledge of foot anatomy improves podiatry coding accuracy, but the physician's documentation is the most important element.
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