2024 Bunionectomy CPT Coding Changes for ASCs
By Paul Cadorette, CPC, COC, CPC-P, COSC, CASCC, director of education, nimble solutions
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In previous years, CPT coding for a diagnosis of hallux valgus and a corresponding bunionectomy procedure was relatively straightforward for ASCs. Coders would select from CPT codes ranging from 28292-28299, depending on the surgical method used for the correction. However, 2024 has brought changes that require both coders and physicians to stay updated on the new code set.
What’s Changed with Bunionectomy?
The American Medical Association (AMA) made a significant update to the CPT codes for 2024. Previously, the code description read as “Correction, hallux valgus (bunionectomy).” Now, it reads “Correction, hallux valgus with bunionectomy.” This adjustment, seemingly minor, emphasizes that when a bunionectomy is performed, it includes the excision or resection of the medial eminence, commonly known as the bunion.
Why the Coding Change?
The AMA’s rationale for this update is to clarify the procedure’s components. There has been confusion due to device manufacturers claiming their products perform a bunionectomy and physicians dictating the procedure as a bunionectomy. However, the most crucial part of any operative report is the confirmation that the medial eminence was excised or resected. Without this specific action, the procedure does not meet the criteria for codes in the 28292-28299 range
CPT Coding Clarifications
If the operative report does not confirm the excision/resection of the medial eminence, alternative codes must be used. For instance:
- A 1st tarsometatarsal joint fusion without excision of the medial eminence should be coded as CPT 28740, not 28297.
- A distal metatarsal osteotomy without the removal of the bunion is coded as 28306, not 28296.
Additionally, a parenthetical note associated with CPT 28297 specifies: “For first metatarsal-cuneiform joint fusion without concomitant removal of the distal medial prominence of the first metatarsal for hallux valgus correction, use 28740.”
Questions Regarding CPT Coding for Bunionectomy
Some coders have questioned why this clarification applies to all codes in the 28292-28299 range and not just to CPT code 28297. It’s important to note that all these CPT codes now include the phrase “with bunionectomy,” which means the removal of the bunion is an integral part of the procedure for each code.
Final Thoughts on 2024 Bunionectomy CPT Coding Changes
It’s crucial for ASC coders to familiarize themselves with these updates to ensure accurate coding and billing. The AMA’s changes aim to streamline and clarify the coding process for hallux valgus corrections, ultimately benefiting patient care and billing accuracy.
Stay informed and diligent in reviewing operative reports to ensure that all coding accurately reflects the procedures performed.
Learn more about bunionectomy coding and coding updates for ankle, foot, and toes procedures in the upcoming Anatomy of Coding course, and earn CEUs from AAPC for attending – more information can be found here.
Sharpen your skillset by registering for nimble’s monthly coding courses, the Anatomy of Coding educational series, available live and on-demand. Access the 2024 course catalog.