Podiatry Coding & Billing Alert

Question: Our clinic has a number of patients seeking treatment for pain in the sole of the foot. As a result, our physician administers a lot of steroid injections and  njections of anesthetic. How should I code these? Is there any critical information that I need to know when reporting these procedures?

North Carolina Subscriber

Answer: Use 64455 (Injection[s], anesthetic agent and/or steroid, plantar common digital nerve[s] [e.g., Morton's neuroma]). You should also use the proper J code to indicate the type of steroid injection with 64455.

Podiatrists often administer steroid and anesthetic injections on the foot to treat Morton's neuroma, a frequently occurring injury of the forefoot that affects the third web space of the toes. During the procedure, the podiatrist injects either an anesthetic agent or a steroid into the planter common digital nerve from the dorsal direction.

Watch out: CPT introduced 64455 in 2009. Make sure you do not list this code in conjunction with another code, 64632 (Destruction by neurolytic agent; plantar common digital nerve), for the same foot. In 64632, the physician uses chemical (neurolytic substance such as alcohol, phenol, glycerol), thermal (heat), electrical (electric current), or radiofrequency techniques (solar or microwave current), independently or in combination, to destroy the nerve causing chronic pain.

Both 64455 and 64632 address pain in the plantar common digital nerve. Therefore, your podiatrist would perform only one procedure for the ailment per foot at one time.