Podiatry Coding & Billing Alert

Question: A podiatrist performs a strapping procedure on the big digit of the patient's right foot. She also injects a therapeutic agent into the left foot. Should I report 29550 and CPT 20550 as separate procedures?

Colorado Subscriber

Answer: Yes. The CCI bundles CPT 20550 (Strapping; toes) into 29550 (Injections[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar "fascia"]). However, your podiatrist performed the procedures in different anatomic locations, so you can bypass the bundling edit by appending modifier 59 (Distinct procedural service) to 29550.

Caution: If you're reporting a separately identifiable E/M service with another procedure on the same day, do not report modifier 59. Instead, use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) for E/M services. You may use modifier 59 to identify procedures that are distinctly separate from another procedure provided by your podiatrist on the same day, and append it to your claim when your physician:

• sees a patient during a different session,
• treats a different site or organ system,
• makes a separate incision/excision,
• tends to a different lesion, or
• treats a separate injury.

-- Answers to You Be the Coder and Reader Questions were reviewed by Arnold Beresh, DPM, CPC, of Peninsula Foot and Ankle Specialists PLC in Hampton, Va.