Podiatry Coding & Billing Alert

Question: I’m new to podiatry. Can you explain the difference between codes 64704 and 64726?

Texas Subscriber

Answer: The codes you mention are 64704 (Neuroplasty; nerve of hand or foot) and 64726 (Decompression; plantar digital nerve).

Code 64704: During a 64704 service, the podiatrist places an incision dorsally into the target site in the patient’s foot where the compressed nerve is located. He then finds the compressed nerve and performs external neurolysis. He may also remove any bone spur or damaged muscle that is putting pressure on the nerve. Finally, he closes the incision in layers once he has repaired and freed the nerve.

Code 64726: When a podiatrist performs a 64726 service, he performs nerve decompression of the plantar digital nerve. Nerve decompression of the freeing a nerve from the surrounding tissues by cutting those tissues with a sharp object.

During a 64726 procedure, the podiatrist an incision dorsally, near the web space between two toes. He deepens the incision below the subcutaneous tissues. He then exposes the ligament where the nerve is compressed due to overgrowth or shrinking of surrounding ligament tissue, enclosing the nerve. He uses a sharp instrument to dissect the ligament tissue and creates space for the nerve. After confirming decompression of the nerve, he closes the skin and subcutaneous layer with sutures.

Don’t miss: You can also report +64727 (Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis)) if the podiatrist documents performing internal neurolysis with the help of an operating microscope. You can report +64727 with codes 64702 (Neuroplasty; digital, 1 or both, same digit)-64726.