Podiatry Coding & Billing Alert

Question: This is somewhat new to me, but apparently Blue Cross Blue Shield (BCBS) does not like the diagnosis of 734 for flat feet. Here is the situation: Our patient has "flexible flat feet," and his father had Marfans syndrome (759.82). I am confused because I have billed 734 to BCBS and have been denied. Research via the Web has not really helped me. Can you provide some insight into coding for "flat feet?"

Missouri Subscriber

Answer: The American Podiatric Medical Association's (APMA) "APMA 2008 Coding

Manual: The Comprehensive Source for Podiatric Physicians" reports that the diagnosis code should be 734.0 (Flat foot, pes planus, talipes planus, acquired). However, some insurers consider this non-covered due to the terminology that this is "acquired" or a congenital deformity. If you report 734 (Flat foot) instead of 734.0, this may cause denial or the policy may exclude this diagnosis from coverage. A phone call to the insurer may clear this up if this is the case. And, just because BCBS has covered this in the past, they may not cover it now.

The insurance companies have a multitude of policies that the individual employers can choose from and may exclude certain conditions that may exclude orthotics and such.