Podiatry Coding & Billing Alert

Code M72.2 is not a blanket code that covers any condition associated with the plantar fascia.

Plantar fasciitis, the most common form of hindfoot pain, is a condition your podiatrist may see often in their office. To be successful when reporting plantar fasciitis, you must always confirm that the diagnosis is indeed plantar fasciitis, and you must know which treatment technique the podiatrist used.

Ask yourself the following FAQs about plantar fasciitis to keep your claims on point.

Choose This Dx Code for Plantar Fasciitis

FAQ 1: Which ICD-10 code should I use to report plantar fasciitis?

Answer 1: Plantar fasciitis is the inflammation of the plantar fascia, which is a thick aponeurosis that supports the arch on the bottom (plantar side) of the foot. When your podiatrist diagnoses a patient with plantar fasciitis, you should report M72.2 (Plantar fascial fibromatosis). If you look in the ICD-10 manual, you will notice that plantar fasciitis is an included diagnosis for M72.2.

Caution: Code M72.2 is not a blanket code that covers any condition that may be associated with the plantar fascia. Always read the medical record carefully to make sure you understand exactly which diagnosis your podiatrist documented.

Podiatrist Performed Injection for Plantar Fasciitis? Do This

FAQ 2: My podiatrist administered a cortisone injection directly to the patient’s plantar fascia to treat his plantar fasciitis. I think I should report 20550 for this procedure, but my colleague disagrees and says it should be 20605. Which CPT^® code is correct?

Answer 2: You are correct. You should report 20550 (Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia”)) for an injection of the plantar fascia. The code descriptor for 20550 specifies “aponeurosis (eg, plantar ‘fascia’).” Code 20605 (Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance) is not the correct injection for plantar fascia because the plantar fascia is not a joint or bursa. It is an aponeurosis.

Differentiate Between Plantar Fasciitis Repair Options

FAQ 3: What are the surgical codes to choose from when it comes to plantar fasciitis surgery?

Answer 3: You have several codes to choose from for plantar fascia repair. Take a look at the difference in the codes, according to Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan:

• When the podiatrist cuts the plantar tendon at the level of the toe or a portion of the plantar fascia at the proximal portion of the plantar fascia, then you would report 28008 (Fasciotomy, foot and/or toe). Code 28008 is most often done as a percutaneous procedure, Beresh says.
• When the podiatrist cuts and removes a piece of the plantar fascia, then you would report 28060 (Fasciectomy, plantar fascia; partial (separate procedure)). You should report 28060 for the partial removal of the plantar fascia using high frequency electrosurgery, per CPT^® Assistant Vol. 18, No. 3. “Code 28060 is neither tool nor technique dependent.”
• When the podiatrist removes one third of the plantar fascia or more, you should report 28062 (Fasciectomy, plantar fascia; radical (separate procedure)).
• When the podiatrist performs a repair or reconstruction of the plantar fascia, such as the repair of a rupture plantar fascia, you should report 28250 (Division of plantar fascia and muscle (eg, Steindler stripping) (separate procedure)).

Turn to 28890 for Plantar Fascia ESWT

FAQ 4: My podiatrist administered high energy sound waves to the sole of the patient’s foot to stimulate healing of the plantar fascia. The podiatrist used ultrasound guidance as a directional aid. The podiatrist performed the procedure with the patient under regional anesthesia.

Answer 4: You would report 28890 (Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia) for this procedure. You should only report 28890 if the podiatrist performs this procedure under general or regional anesthesia.

You should not report 28890 in conjunction with 0512T (Extracorporeal shock wave for integumentary wound healing, high energy, including topical application and dressing care; initial wound) or +0513T (… each additional wound (List separately in addition to code for primary procedure)) when the podiatrist treats the same area, according to CPT^®.

Extracorporeal shock wave therapy (ESWT) defined: High energy sounds waves administered under regional or general anesthesia to promote healing of tissues in plantar fasciitis, a condition in which the connective tissue supporting the arch of the foot becomes inflamed and painful, and lateral epicondylitis, or tennis elbow, in which the tendons of the elbow become inflamed and painful from repetitive use.

Don’t miss: Many payers will not authorize this procedure or approve it only for specific diagnoses and under specific delivery conditions. Preauthorization is highly recommended.