tci Part B Insider - 2015 Issue 2

Reader Question: Look for Combo Codes When You Can

Question: One of our physicians is trying to bill for a bunionectomy with 28292 (Correction, hallux valgus [bunion], with or without sesamoidectomy; Keller, McBride, or Mayo type procedure) and an osteotomy using 28306 (Osteotomy, with or without lengthening, shortening or angular correct, metatarsal; first metatarsal) on the same big toe. She asked us to append modifier 59 (Distinct procedural service) to 28306 so the payer would reimburse us for both, but we aren’t sure if this is accurate advice. Can you advise? Answer: Unless the surgeries were performed in different locations (e.g., one on the left foot...

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