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AHA Coding Clinic® for HCPCS - 2021 Issue 1; For Your Information

Metatarsophalangeal joint and plantar plate repair

A patient presented with a left ruptured plantar plate, dorsal contracture with subluxation and ruptured flexor tendons of the second metatarsophalangeal joint. Both dorsal and plantar incisions were made over the second metatarsophalangeal joint. Through the dorsal incision, a capsulotomy was made and previously placed hardware was removed. Through the plantar incision, drill holes were created in preparation for the plantar plate repair with an InternalBrace™ and the use of Arthrex screws. Once the Fiber tape and anchors were placed, the flexor tendons were repaired by suturing the tendons into the distal portion of the repaired plantar plate at the base of the proximal phalanx. GraftJacket dermal allograft was placed from dorsal to plantar to over lay the degenerative second metatarsal head. It was then sutured into the plantar joint capsule and plantar plate correcting the metatarsophalangeal joint subluxation. Is it appropriate to assign CPT codes 28645 and 28899 for dorsal subluxation repair of the metatarsophalangeal joint with internal brace and plantar plate repair with graft jacket? ...

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