Podiatry Benefit Change Effective Immediately

Community Health Plan of Washington (CHPW) was notified by the Health Care Authority (HCA) that the Bunion procedures listed below were included as covered benefits in error. CHPW follows HCA guidelines. As a result, we will update our Benefit and Fee Schedule Grids to reflect this change immediately.

If you performed any of the procedures listed below, your claims payments may be recouped. For more information, please refer to WAC 182-531-0150, where it outlines that Hallux valgus (bunion) surgery is not a covered benefit.

The following codes will now be listed as non-covered:

  • 28290: Correction, hallux valgus (bunion), with or without sesamoidectomy; simple exostectomy (eg, Silver type procedure)
  • 28292: Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure
  • 28293: Correction, hallux valgus (bunion), with or without sesamoidectomy; resection of joint with implant
  • 28294: Correction, hallux valgus (bunion), with or without sesamoidectomy; with tendon transplants (eg, Joplin type procedure)
  • 28296: Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)
  • 28297: Correction, hallux valgus (bunion), with or without sesamoidectomy; Lapidus-type procedure
  • 28298: Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx osteotomy
  • 28299: Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy

Although we were following guidelines posted by the HCA, we apologize for the error and any inconvenience that this may have caused. If you have any questions, please contact Provider Relations at Provider.Relations@chpw.org, or Customer Service at 1-800-440-1561 (TTY Relay: Dial 7-1-1), Monday through Friday, 8 a.m. to 5 p.m.