Podiatry Coding & Billing Alert

Question: According to the documentation, my podiatrist performed a calcaneal spur resection with plantar fascial release on the left foot. Under C-arm fluoroscopy guidance, they inserted an 18-gauge needle from the heel in a distally placed position aiming toward the spur. C-arm fluoroscopy confirmed the trajectory was correct and right on the spur. My podiatrist replaced the 18-gauge needle with a #15 blade, which they inserted percutaneously and all the way to the spur. Under C-arm fluoroscopy, my podiatrist noted complete release of the medial and central bands of the plantar fascia. They noted good release of the bands. My podiatrist inserted a rasp, and carefully resected the calcaneal spur via C-arm fluoroscopy guidance. C-arm fluoroscopy confirmed excellent reduction of the calcaneal spur and complete resection of the plantar fascia. My podiatrist used sterile saline to irrigate the incision and closed the incision with 4-0 Prolene. Which code should I report on my claim? I was thinking 28119, but the words “fluoro guidance” and “percutaneous” are confusing me.

Ohio Subscriber

Answer: You should report 28119 (Ostectomy, calcaneus; for spur, with or without plantar fascial release) on your claim. The code descriptor does not specify the method in which the bone is excised. Report 28119 regardless of whether the podiatrist makes release incisions on the stressed or irritated plantar fascia.