10/21/2020    

CODINGLINE CORNER

Query: Akin and an Implant

 

I have a patient who will undergo a Cartiva implant procedure for hallux limitus/rigidus at the 1st metatarsophalangeal joint. He also has lateral deviation of his hallux on the same foot and an Akin osteotomy will be performed to address this deformity. Should the Akin osteotomy be billed as a separate procedure or is that considered unbundling?

 

Dave Williams, DPM, El Paso, TX

 

Response: I think you will find that most insurance carriers will only pay for the phalangeal osteotomy of the hallux if performed “separately” as an isolated procedure of the first toe. Since you are performing the implant on the first toe joint, it would most likely be combined with the primary implant procedure and not paid. You always have the option to ask for individual consideration if there are extenuating circumstances. If you decide to go this route, provide a copy of the operative report and a cover letter describing the unique situation that deserves additional payment. Request peer review from the carrier.

 

Howard Zlotoff, DPM, Camp Hill, PA

 

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