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Tip: Know the common bunionectomy procedure codes and how to use them

Ambulatory Surgery Reimbursement Update, July 8, 2008

The most commonly performed bunionectomy procedures are the Austin and Akin procedures. Here are some tips to be sure you are coding them correctly:

  • Use code 28296 to report an Austin bunionectomy procedure. This procedure involves a metatarsal osteotomy performed with or without a sesamoidectomy. You should also use this code to report Reverdin-Green osteotomy, Reverse Austin, Mitchell, Chevron, Kalish, Youngswick, Reverdin, Hohmann, and LaGreshino bunionectomy procedures.
  • Report the Akin bunionectomy procedure with code 28298. This procedure involves the removal of a medially-based bony wedge from the base of the proximal phalanx (phalanx osteotomy) to correct its axis. Physicians perform this procedure when there is little or no angulation of the first metatarsal and it will not offer a satisfactory response for a major bunion deformity.
  • If the physician performs both the Austin and Akin procedures on the same toe, don’t code both procedures separately—they are unbundled in the National Correct Coding Initiative (NCCI) material. For a double osteotomy procedure use code 28299 instead of codes 28296 and 28298. A physician may perform this procedure for severe hallux valgus or a congruent joint. Any bunion procedure performed that involves a combination of two osteotomy procedures should be coded with the 28299 code, instead of being coded out separately.

This tip is brought to you by Ellis Medical Consulting, Inc.