Podiatry Coding & Billing Alert

Question: The podiatrist carried out a removal of the calcaneal spur and released the plantar fascia on the left foot. Using C-arm fluoroscopy for guidance, they inserted an 18-gauge needle from the heel, aiming it towards the spur. The C-arm fluoroscopy verified the correct positioning and alignment with the spur. The podiatrist then replaced the 18-gauge needle with a #15 blade, which was inserted through the skin and directed to the spur. The podiatrist observed the complete release of the medial and central bands of the plantar fascia under the C-arm fluoroscopy as well as a satisfactory release of the bands. The podiatrist then inserted a rasp and carefully removed the calcaneal spur under the guidance of the C-arm fluoroscopy. The C-arm fluoroscopy confirmed a successful reduction of the calcaneal spur and complete removal of the plantar fascia. Finally, the podiatrist cleaned the incision with sterile saline and closed it with 4-0 Prolene. Which code should I report on this claim?

AAPC Forum Participant

Answer: You should report 28119 (Ostectomy, calcaneus; for spur, with or without plantar fascial release) in this case, regardless of whether your podiatrist made release incisions on the stressed or irritated plantar fascia. You should also check the operative note to confirm any fasciotomy your podiatrist performed.

Ostectomy defined: An ostectomy is the surgical removal of a bone (partially or completely).

Coding note: If your podiatrist only excises a heel spur and removes a part of the calcaneus, you should report 28118 (Ostectomy, calcaneus) instead.