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03/10/2004    Brian Connor, DPM

Repair Plantar Plate and Hammertoe

Query: Repair Plantar Plate and Hammertoe

I am looking for some help in coding the repair
of a plantar plate in conjunction with a flexor
tendon transfer/hammertoe repair (the digit is
crossed over an adjacent toe). Specifically,
does anyone have a recommendation on a CPT to
use for the repair of the plantar plate with the
hammertoe correction?

Brian Connor, DPM
Altamonte Springs, FL

Codingline Response: Most insurance companies,
whether it seems reasonable or not, will bundle
all soft tissue and bone procedures related to
repair of hammertoe into CPT 28285 (hammertoe
correction, e.g., interphalangeal fusion,
partial or total phalangectomy).

Since there is no specific code for repair of
flexor plate, I suggest adding modifier "-22" to
CPT 28285 indicating that this procedure was
greater than the usual code, and deserves more
compensation. By sure to include an operative
report, and request peer review with your
insurance claim.

Howard Zlotoff, DPM
Camp Hill, PA

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