Podiatry Coding & Billing Alert

Question: Our podiatrist administered steroid injections on a patient's big toes on both right and left feet, to treat chronic pain arising from Morton's neuroma. What codes apply for this procedure and how should we report it?

Nevada Subscriber

Answer: Use 64455 (Injection[s], anesthetic agent and/or steroid, plantar common digital nerve[s]).

Don't miss: Since your podiatrist administered the injections on the left and right big toes, the procedure qualifies as a bilateral one. Report 64455 twice: once with modifier RT (Right side) attached and once with LT (Left side) attached.

64455 is one of two CPT codes introduced in 2009 specifically for plantar common digital nerve procedures. The other is 64632 (Destruction by neurolytic agent; plantar common digital nerve). 64455 replaced 64450 (Injection, anesthetic agent; other peripheral nerve or branch) and 64632 replaced 64640 (Destruction by neurolytic agent; other peripheral nerve or branch). While the 2009 codes pay less than the old codes, they will help you increase your coding accuracy because they are more specific.

Clinical explanation: Morton's neuroma, a thickening of the plantar nerve between the heads of the metatarsals, is a condition affecting plantar digital nerves.