This page addresses follow-up questions and additional information pertinent to our webinar
Procedure Coding for Lower Extremity Amputations.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: Can you give an example on when the 79 modifier would be used for an amputation when the patient is in the post operative period?
A: A good example would be if a patient has their small toe amputated for gangrene and then two months later the patient started developing an ulcer with osteomyelitis requiring the big toe be amputated. Those would be unrelated; therefore the -79 modifier would be appropriate.
Q: Can you explain what the term ray amputation means?
A: It’s when the surgeon removes a finger or toe and the associated metatarsal or metacarpal. This type of amputation can preserve function and have a nicer cosmetic outcome.
Q: Is the removal of the ankle bone (malleoli) included in CPT 27888?
A: Yes, it is included. The CPT definition for 27888 covers “with or without tibia and fibula shortening.” To create a flat, weight-bearing surface for a Syme amputation, the surgeon must remove the lower portions of the tibia and fibula, including the medial and lateral malleoli. This is considered an integral part of the procedure and is not separately billable.
Looking for additional information on this topic?
Meet the Presenter: Mary Bort, CPC, CPMA, CANPC, CASCC, COSC
Mary is a Senior Coding Quality Auditor for The Haugen Consulting Group with over 25 years of health care industry experience. She started her career in Orthopedics which was her passion for decades. In addition to Orthopedics, she provides expertise in other specialties such as Anesthesia, Ambulatory Surgery Center, as well as most surgical specialties . She has experience working the professional fee side of coding, audit, education as well as compliance, serving both coders and physicians, as well as the surgical side. She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Anesthesia Professional Coder (CANPC) Certified Ambulatory Surgery Center Coder (CASCC) and Certified Orthopedic Surgery Coder (COSC).
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