Podiatry Coding & Billing Alert

You'll jump for joy at the one change this quarter's Correct Coding Initiative (CCI) edits brings for podiatry coding.

Effective for dates of service beginning April 1, 2010, code 64455 (Injection[s], anesthetic agent and/or steroid, plantar common digital nerve[s] [eg, Morton's neuroma]) now has a modifier indicator of "1," reports Richard Odom, DPM, ABPS, CPC, a practicing podiatrist at Gulf Coast VA Hospital System in Mobile, Ala. In the past, the modifier indicator has been "0."

Change: You now are able to append a modifier, such as 59 (Distinct procedural service), to one of the following column two codes when appropriate, allowing you to break the CCI bundle with 64455:

• 29515 -- Application of short leg splint (calf to foot)
• 29540 -- Strapping; ankle and/or foot
• 29550 -- Strapping; toes
• 29580 -- Strapping; Unna boot
  29590 -- Denis-Browne splint strapping
  J2001 -- Injection, lidocaine hcl for intravenous infusion, 10 mg.

Example: A patient presents with a history of Morton's neuroma (355.6, Lesion of plantar nerve) on the left foot, but also has an additional presenting complaint of right plantar heel pain. In this scenario, the patient could be diagnosed with a neuroma in the left foot, and plantar fasciitis (728.71, Plantar fascial fibromatosis) of the right foot. If the provider made an injection to treat the Morton's neuroma (64455) on the left foot and elected to treat the plantar fasciitis involving the right foot with a taping or strapping (29540) then you could append modifier 59 to 29540 to identify separable services, Odom explains. Previously, you could not be reimbursed for both 64455 and 29540 on the same date of service.