Podiatry Coding & Billing Alert

Question: The podiatrist diagnosed the patient with plantar fasciitis. What ICD-10 and CPT^® codes should we report?

Virginia Subscriber

Answer: Most plantar fasciitis pain is located close to where the fascia attaches to the heel bone. The exact cause of plantar fasciitis is unknown, but once your physician diagnoses plantar fasciitis, you'll normally report M72.2 (Plantar fascial fibromatosis).

Plantar fasciitis definition: Plantar fasciitis is the most common form of hindfoot pain. When patients have this condition, the plantar fascia, a thick aponeurosis that supports the arch on the bottom (plantar side) of the foot, becomes inflamed and painful.

Caution: Some coders may confuse plantar fasciitis with a plantar fibroma or plantar fascia rupture/tear, but M72.2 is not a blanket code that covers all of these conditions.

For a plantar fibroma, you would code D21.2- (Benign neoplasm of connective and other soft tissue of lower limb, including hip) instead. And, if the patient has an acute injury like a tear or rupture, then you would look in the S96.81- (Strain of other specified muscles and tendons at ankle and foot level) section and code it as the injury.

CPT^® codes: If the patient's pain does not improve with initial treatments like stretches, taking an anti-inflammatory drug, custom-made orthotics, etc., the physician may suggest corticosteroid shots, which you would code as 20550 (Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia")).

Although nonsurgical options do prove successful for the majority of patients, some people may need surgery to treat their plantar fasciitis. Depending on the complexity of the surgery, you should select one of these four codes, all of which refer to plantar fascia repair:

• 28008 (Fasciotomy, foot and/or toe)
• 28060 (Fasciectomy, plantar fascia; partial (separate procedure))
• 28062 (Fasciectomy, plantar fascia; radical (separate procedure))
• 28250 (Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure)).