Podiatry Coding & Billing Alert

Question: For a patient with Morton’s neuroma, the podiatrist documented a release of the dorsal nerve entrapment and an excision of stump neuroma. Do I bill this with 28080 or 64704?

North Carolina Subscriber

Answer: In this situation, you would code 28080 (Excision, interdigital (Morton) neuroma, single, each) for the removal of the neuroma. This service describes the removal of the neuroma, whereas 64704 (Neuroplasty; nerve of hand or foot) describes the decompression of the nerve. Essentially, you would regard 64704 as a component service of the primary 28080.

This is why National Correct Coding Initiative (NCCI) edits bundle both services together and require an NCCI-associated modifier to unbundle them when 64704 is the column 2, or component, code to 28080.

This will enable you to get paid for both procedures when your podiatrist is performing the procedures on two different nerves or on nerves in different anatomic locations.

And don’t forget to add the correct diagnosis code from G57.6- (Lesion of plantar nerve) to indicate medical necessity for the 28080, as Morton’s metatarsalgia is a synonym for the code. You’ll add the appropriate 5th character from 1 (… right lower limb), 2 (… left lower limb), or 3 (… bilateral lower limb) to indicate laterality.