Tackle Turf Toe Injury Coding With These Tips – Part 2
Is there a specific turf toe treatment procedure code? Turf toe is a painful injury that is common among athletes. The condition affects the metatarsophalangeal (MTP) joint and plantar plate ligament in the foot. As a podiatry coder, you should familiarize yourself with the procedures podiatrists perform to treat the patient’s condition, so you can accurately code cases for reimbursement. In this second part of the series, you’ll learn about procedure codes for surgical and nonsurgical treatments of turf toe. Explore Turf Toe Treatment CPT® Codes Let’s review the different CPT® coding options for turf toe injuries. The treatment approach varies depending on the severity and duration of the injury. After the initial assessment, the healthcare provider will decide whether conservative methods or proceeding with surgery is the most appropriate path for the patient. Examine E/M Visits You’ll bill the initial visit for a turf toe diagnosis using a standard evaluation and management (E/M) code, such as those from the 99202-99215 (Office or other outpatient visit for the evaluation and management …) range. The level of complexity, documentation, and medical decision making will determine the specific E/M code. As mentioned above, the podiatrist may order imaging exams to evaluate the foot. A foot X-ray to check for fractures is common. The specific code depends on the views taken. For example, for a three-view X-ray, 73630 (Radiologic examination, foot; complete, minimum of 3 views) would be appropriate. On the other hand, if the provider suspects a severe ligament or plantar plate tear, they might order an MRI. Use 73721 (Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material) to report a lower extremity joint MRI without contrast. Nail Down Nonsurgical Procedures Nonsurgical treatments for turf toe include strapping or taping, casts, and orthotics. Assign 29540 (Strapping; ankle and/or foot) for the application of supportive taping on the ankle and foot or 29550 (… toes) for the toes. If the provider applies a cast to immobilize the toe while it heals, then you’ll use 29405 (Application of short leg cast (below knee to toes)) for the application of a lower extremity walking cast. Additionally, report 97760 (Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes) for the prescription and fitting of orthotics. For rehabilitative exercises and other therapeutic activities, you may report the following codes: Sort Out Turf Toe Surgical Procedure Codes The CPT® code book does not contain a single, direct code for turf toe repair; rather, the coding depends on the specific surgical procedure performed, often involving codes like 28313 (Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)) for soft tissue reconstruction of a toe deformity, or the unlisted procedure code 28899 (Unlisted procedure, foot or toes) for plantar plate repairs. Other codes for specific repairs include 28270 (Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)) for MTP joint capsulotomy, or 28232 (Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)) for flexor tendon tenotomy. The surgeon may also perform associated surgical bone work; you’d report 28308 (Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each) for a Weil osteotomy, for example. Follow These Steps to Determine the Correct CPT® Code Keep These Considerations in Mind Knowing when and how to report an unlisted code like 28899 is important. If a specific code does not precisely describe the service, 28899 is an option. A manual claim, including the operative report and any associated documentation, is required for submitting unlisted codes. Before the procedure takes place, you’ll want to confirm if the payer needs to know about it. Contact the individual payer to determine if preauthorization is needed for the specific procedure. Remember to review National Correct Coding Initiative (NCCI) edits. Pay attention to coding guidelines regarding bundled procedures, as some procedures may not be separately billable with others. This comprehensive overview of turf toe injuries is intended to support accurate diagnosis and procedure coding. Keep in mind there is not a single CPT® code for the repair of these injuries. Always review the provider’s detailed operative report before assigning a code. If any questions or uncertainties arise regarding the appropriate code for the repair, the best practice is to consult the provider for clarification and ensure the record is updated accordingly. Series recap: Check out Part 1 of the series, where Revenue Cycle Insider examined the turf toe condition and the ICD-10-CM codes. Jessica Sullivan, CPC, COSC, COBGC, Consultant, Professional Audit,
Coding & Education Services (PACE)
