If you neglect to report multiple fractures, it could cost you $500 per metatarsal.
Lisfranc joint injuries can pop up in just about any patient, right from athletes to the elderly. Scoop up all of the multiple repair payments you have earned and learn when accurate modifiers can pep up revenue with this inside look at Lisfranc repair coding.
Code for each fracture repair
Remember to treat a repair to each fractured metatarsal bone as one unit.
When the podiatrist uses the common open reduction internal fixation (ORIF) technique to repair a fracture to the Lisfranc area, go for 28485.
Do not miss: Code one unit or 28485 for each metatarsal fracture. Based on the anatomy, you would normally report three units of 28485. Add modifier 59 to 28485 beginning with the second line item.
Reimbursement: CPT carries 13.89 physician work RVUs, according to the 2010 Medicare Physician Fee Schedule. That comes down to $501.14 per metatarsal based on the updated 2010 national conversion factor of $36.0791.
A note of caution: Remember that 28485 represents fractures in separate metatarsals, and not multiple fractures within the same metatarsals. If one metatarsal contains multiple fractures, go for only one unit of 28485.
For more on this, register yourself for a one-stop medical coding website. When you sign up for one, you will get all updates on the molecular diagnostics prep pay you deserve along with all 2010 CPT codes online. Such a site will supercharge your ethical reimbursements through codesets, content and community. So sign up for one medical coding website today and see the difference it brings to your practice.