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What is the CPT code for hammer toe surgery?

Hammertoe repair and bunion procedures. Hammertoe repair (CPT code 28285) is not listed as an inclusive procedure to a hallux valgus correction procedure, but Medicare CCI edit for CPT code 28296 and 28285 requires appending the modifiers to appropriately override the payor edits.

What is included in CPT 28285?

CPT 28285 includes the examples of interphalangeal fusion, partial or total phalangectomy).

What does CPT code 28285 mean?

Reconstruction Procedures
CPT® 28285 in section: Repair, Revision, and/or Reconstruction Procedures on the Foot and Toes.

Is hammer toe surgery covered by insurance?

Hammer toe is usually covered by insurance or Medicare if the condition is deemed medically necessary. Your doctor may consider the surgery medically necessary if: you’re experiencing pain.

What is included in CPT 28296?

metatarsal osteotomy
CPT 28296 is reported to correct a hallux valgus deformity with a distal metatarsal osteotomy. The procedure includes sesamoid bone removal, when necessary, to help with bone realignment.

Does Medicare pay for hammertoe surgery?

Medicare will generally cover Hammertoe surgical procedures. But your doctor must decide that it’s necessary for your health. Hammertoe can cause severe pain and can affect the health of your foot. If you have significant pain or balance issues, you may qualify for hammertoe surgery.

What replaced CPT 28290?

The CPT codes 28290, 28293 and 28294 have been deleted. These no longer exist. Never use them again. Code CPT 28296 was modified to: Bunionectomy with distal metatarsal osteotomy.

How long does a PIN stay in a toe after hammertoe surgery?

You will have a pin in your toe for 4 weeks after surgery. This pin will be removed in the office at your second post-op appointment. You will be given a post-op shoe to use after surgery. You should use this shoe for walking for a total of 4 weeks after surgery.

When is surgery necessary for hammertoe?

Hammer toe is usually covered by insurance or Medicare if the condition is deemed medically necessary. Your doctor may consider the surgery medically necessary if: you’re experiencing pain. the hammer toe is affecting your balance. the hammer toe is affecting your general foot health.

When should you consider hammertoe surgery?

If you have multiple foot problems , your doctor may recommend treating all of them in one operation. You should avoid hammer toe surgery if you have: poor circulation in your feet. an active infection. health problems that would make surgery risky .

When does hammertoe require surgery?

Rigid hammertoes. If the tendons in your toe get rigid, they press the joint out of alignment. At this stage, you can’t move your toe. It usually means you need surgery.

How long is recovery for hammer toe surgery?

The healing process for bunion and hammertoe surgery continues for 3 to 12 months after surgery. Straining your foot soon after your surgery may lead to a poor outcome and continued pain. You may return to work when your doctor clears you to do so.