How To Use CPT Code 28299

CPT 28299 describes a specific procedure for the correction of hallux valgus, commonly known as a bunion, on the side of the foot. This article will provide an overview of CPT code 28299, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 28299?

CPT 28299 is a code used to describe a specific procedure for the correction of hallux valgus, or a bunion, on the side of the foot. This procedure involves a double osteotomy, which is the combining of two osteotomy procedures. The provider may make two incisions in the first metatarsal bone of the foot or incise the metatarsal and the bone of the big toe to correct the deformity and restore function.

2. Official Description

The official description of CPT code 28299 is: ‘Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with double osteotomy, any method.’

3. Procedure

1. The provider begins by making an incision over the first metatarsal, the bone of the foot connected to the big toe.
2. Small vessels along the path are clamped and coagulated to minimize bleeding.
3. The provider may remove the enlarged bump of bone on the side of the foot.
4. Next, the provider accesses the target site of the metatarsal bone near its connection with the big toe.
5. A combination of two osteotomy procedures is performed, such as incision of the proximal metatarsal and the distal metatarsal, or two osteotomies of the distal metatarsal and proximal big toe bone.
6. Fixation devices are used to hold the bones in the desired position.
7. During the procedure, the provider may also perform a sesamoidectomy, which involves the removal of a sesamoid bone located under the big toe joint.
8. Finally, the provider checks for bleeding and closes the incision.

4. Qualifying circumstances

CPT 28299 is used for patients with hallux valgus, a deformity that causes the big toe to bend toward the second toe. The procedure is performed to reduce symptoms, restore function, and correct the deformity. The patient must have a documented need for the correction, and the procedure must involve a double osteotomy, regardless of the specific method used.

5. When to use CPT code 28299

CPT code 28299 should be used when a provider performs a correction procedure for hallux valgus with a double osteotomy. It is important to note that this code should only be used when a sesamoidectomy is also performed during the procedure. If the procedure does not involve a double osteotomy or a sesamoidectomy, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT code 28299, the provider must document the following information:

• Patient’s diagnosis of hallux valgus and the need for correction
• Details of the double osteotomy procedure performed
• Documentation of the sesamoidectomy, if performed
• Date of the procedure
• Any additional procedures or services provided during the same encounter
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 28299, ensure that the procedure meets the qualifying circumstances and includes a double osteotomy and a sesamoidectomy. It is important to review all codes in the range 28289 to 28299 before finalizing the billing. Additionally, consider any specific guidelines provided by payers or insurance companies to ensure accurate billing and reimbursement.

8. Historical information

CPT code 28299 has undergone historical changes. On January 1, 2017, the code was changed to its current description. Prior to that, on January 1, 2002, the code was also changed to include the option of using other methods for the correction procedure. CPT code 28299 was initially added to the Current Procedural Terminology system on January 1, 1990.

9. Examples

1. A podiatrist performs a correction procedure for hallux valgus with a double osteotomy and sesamoidectomy on a patient with severe bunions.
2. An orthopedic surgeon corrects hallux valgus deformity using a double osteotomy and sesamoidectomy for a patient experiencing significant pain and difficulty walking.
3. A foot and ankle specialist performs a bunion correction procedure with a double osteotomy and sesamoidectomy on a patient with a history of recurrent bunions.
4. A patient with hallux valgus undergoes a correction procedure with a double osteotomy and sesamoidectomy to improve foot function and alleviate discomfort.
5. A provider performs a double osteotomy and sesamoidectomy to correct a severe hallux valgus deformity in a patient who has failed conservative treatments.
6. An orthopedic surgeon performs a bunion correction procedure with a double osteotomy and sesamoidectomy on a patient with a family history of bunions and significant pain.