Medicare Benefits Schedule - Note TN.8.292

Items 48442 and 48444 each provide for the removal of one or more exostoses when undertaken via the same incision.

Where multiple incisions are made to access the same exostosis, the relevant item should only be claimed once.

For the removal of exostoses in the hip and leg on the same occasion:

• Where exostoses are removed from the hip and leg via separate incisions, items 48442 and 48444 may both be claimed.
• Where exostoses are removed from the hip and leg via a single, common incision, only item 48444 should be claimed.

Services for the removal of exostoses in the foot and ankle should be claimed under item 48430. For the removal of exostoses in the leg and ankle on the same occasion:

• Where exostoses are removed from the leg and ankle via separate incisions, items 48444 and 48430 may both be claimed.
• Where exostoses are removed from the leg and ankle via a single, common incision, only item 48430 should be claimed.

These items are not to be used in addition to an item for another arthroscopy, arthrodesis, arthroplasty, osteotomy, or removal of hardware where those procedures are performed on the same joint or bone.

Related Items: 48430 48442 48444

• Previous - Note TN.8.291
• Next - Note TN.9.1

Multiple Operation Rule

Excision of one or more osteophytes of the foot or ankle, or simple removal of bunion, including any of the following (if performed):

(a) capsulotomy;

(b) excision of surrounding osteophytes;

(c) release of ligaments;

(d) removal of one or more associated bursae or ganglia;

(e) removal of bone;

(f) synovectomy;

—each incision (H)

(Anaes.) (Assist.)

Fee: $295.30 Benefit: 75% = $221.50

(See para TN.8.196, TN.8.199, TN.8.200, TN.8.201, TN.8.292 of explanatory notes to this Category)

Multiple Operation Rule

Excision of one or more exostoses in the hip, including pelvis and femur, including any of following (if performed):

(a) capsulotomy;

(b) excision of surrounding osteophytes;

(c) release of ligaments;

(d) removal of one or more associated bursae or ganglia;

(e) removal of bone;

(f) synovectomy;

other than:

(g) a service to which 48444 applies; or

(h) a service associated with a service to which another item in this Schedule applies that:

(i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(ii) is performed on the same joint or bone;

—each incision (H)

(Anaes.) (Assist.)

Fee: $295.30 Benefit: 75% = $221.50

(See para TN.8.292 of explanatory notes to this Category)

Multiple Operation Rule

Excision of one or more exostoses in the knee, tibia or fibula, including any of following (if performed):

(a) capsulotomy;

(b) excision of surrounding osteophytes;

(c) release of ligaments;

(d) removal of one or more associated bursae or ganglia;

(e) removal of bone;

(f) synovectomy;

other than:

(g) a service to which item 48430 applies; or

(h) a service associated with a service to which another item in this Schedule applies that:

(i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and

(ii) is performed on the same joint or bone;

—each incision (H)

(Anaes.) (Assist.)

Fee: $295.30 Benefit: 75% = $221.50

(See para TN.8.292 of explanatory notes to this Category)