Podiatry Coding & Billing Alert

Question: The patient, a professional soccer player, has been experiencing tingling and burning into her toes, towards the middle part of her right foot. The podiatrist diagnoses the patient with Morton’s neuroma (G57.61, Lesion of plantar nerve, right lower limb). According to the podiatrist’s treatment plan, he injects a steroid or anesthetic agent for temporary pain relief. Can we report both 64455 and 64632 for this procedure?

Maine Subscriber

Answer: No. You would just report 64455 (Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton’s neuroma). You should never report 64455 in conjunction with 64632 (Destruction by neurolytic agent; plantar common digital nerve), according to the CPT^® manual.

“Because the treatment therapies described by codes 64455 and 64632 are distinctly different, it would not be appropriate to report codes 64455 and 64632 for each of these therapies at the same session,” adds CPT^® Assistant Vol. 19, No. 1.

64455: When your podiatrist treats a neuroma through injections, you should report 64455. Code 64455 provides temporary relief of Morton’s neuroma. The podiatrist gives this injection in the plantar common digital nerve from the dorsal direction. The podiatrist injects a corticosteroid with an anesthetic around the nerve, which relieves the pressure on the nerve.

64632: Report 64632 if the podiatrist uses this procedure through chemical, thermal, electrical, or radiofrequency techniques. “When conservative treatment (eg, alteration of footwear, use of metatarsal pads, foot orthotic devices, steroid injection(s) (code 64455), and/or nonsteroidal anti-inflammatory medications) fails to provide relief of the symptoms, chemical destruction (neurolysis) of the plantar common digital nerve by injection is a treatment option,” according to CPT^® Assistant Vol. 19, No. 1.