Resolved Lapidus/Akin Procedures

[MarisaM_62351]

Hello!
Dx: LT Hallux Valgus deformity
DX: Hallux interphalangeus

Doctor performs Hallux valgus correction through Lapidus type procedure and a proximal phalanx Akin osteotomy. All in same toe.
Would that be:
28297-TA
28298-59,TA

 

[Alicia]

With the information provided yes I believe that is the way I would code that.

28297 - Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method

A bunionectomy involving excision of the medial eminence, tenotomy, and joint fusion of the first metatarsal bone to the first cuneiform bone is performed to correct hallux valgus. A dorsal incision is made over the metatarsophalangeal joint. Soft tissues are dissected and the joint capsule is exposed. The metatarsophalangeal joint capsule is incised and the medial eminence is exposed. The medial eminence is excised in line with the metatarsal shaft. The tendon on the lateral aspect of the great toe is divided. The first metatarsocuneiform joint is resected and the metatarsal bone is realigned. Screw or other suitable arthrodesis fixation is placed across the first metatarsocuneiform joint to maintain the joint in the corrected position and to allow the bones to fuse. The joint capsule is plicated and repaired. The two sesamoid bones located on either side of the metatarsal head may also be excised if they are fractured or inflamed. A skin incision is made over the sesamoid bone. Soft tissues are dissected around the sesamoid bone and the bone is excised. Soft tissue and skin are closed in layers.

28298 - Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal phalanx osteotomy, any method

A proximal phalanx osteotomy or double osteotomy is performed to correct hallux valgus in a bunionectomy procedure. In

28298, a proximal phalanx osteotomy, also referred to as an Akin procedure, is performed. A medial incision is made just proximal to the medial eminence and extended just distal to the interphalangeal joint. Soft tissues are dissected and the joint capsule is exposed. The metatarsophalangeal joint capsule is incised and the medial eminence is exposed. The medial eminence is excised in line with the metatarsal shaft. A medial wedge osteotomy of the proximal phalanx is completed just distal to the phalangeal base. The redundant joint capsule is plicated and closed. In 28299, a double osteotomy is performed, which involves excision of the medial eminence, osteotomy of the proximal phalanx, and an osteotomy of the first metatarsal in addition. Following repair of the joint capsule, the amount of correction needed for the first metatarsal is determined, and the osteotomy on the first metatarsal is then also performed. The two sesamoid bones located on either side of the metatarsal head may also be excised if they are fractured or inflamed. A skin incision is made over the sesamoid bone. Soft tissues are dissected around the sesamoid bone and the bone is excised. Osteotomies are stabilized with Kirschner wires or sutures placed through the distal phalanx, proximal phalanx, and into the distal aspect of the metatarsal bone to maintain the position of the toe.

 

[MarisaM_62351]

Thank you!