Ring in the New Year with this summary of crucial podiatry coding and billing changes.
“This is an odd year, because there are actually a lot of changes to podiatry,” says Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, speaker at the recent 2017 Podiatry Changes and Updates Audio Educator conference.
Anderanin reviewed the major coding changes for podiatrists as well as updates to Medicare’s list of foot care services it deems “medically necessary and reasonable.”
Added Depth to Bone Biopsies
CPT® bone biopsies were revised to clarify the examples of deep or superficial. Deep bones are described as ones you cannot feel, such as the femoral shaft. Superficial bones are ones that you can, such as the femur at the knee. Relevant CPT® codes are:
RVU news: Work RVUs for deep bone biopsies were reduced from 8.95 to 6.00 for 2017. The global period for 20245 remains 10 days in the first quarter of 2017.
Big Changes for Bunions
o ICD-10 introduced 21.61- (Bunion) and M21.62- (Bunionette)
o CPT® codes 28289, 28292, 28296, 28297, 28298 and 28299
o CPT® codes
28290, 28293, 28294
ICD-10 added foot fracture codes:
Routine Foot Care Not Covered by Medicare
CMS reaffirmed that it will not cover what it deems as routine foot care listed below, unless services are performed along with certain vascular, metabolic, or neurologic diseases (such as celiac disease or malnutrition).
Coverage for Congenital Flat Feet, Plantar Fasciitis
Medicare generally doesn’t cover treatment for flat feet. However, while carriers often do not reimburse for treatment of acquired flat feet, they frequently will if it’s congenital. Because 20 to 30 percent of the general population has congenital flat feet, it’s important to code appropriately.
Note: There’s no bilateral code, so in the presence of both you would code each separately.
Despite physicians pointing out that fibroblastic disorders and plantar fasciitis are distinct, ICD-10 says to stick with M72.2 (Plantar fascial fibromatosis) and to code injections once, even if administering multiple injections. Relevant CPT® codes are:
20550 (Injection[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar “fascia”]) — for plantar fasciitis
20551 (Injection[s]; single tendon origin/insertion) — for calcaneal spur
20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]) — for plantar fascia and calcaneal spur.
To see CMS’s updated (but not comprehensive) list of conditions that allow for billing of routine foot care, please visit: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedicarePodiatryServicesSE_FactSheet.pdf.