Podiatry Coding & Billing Alert

Question:  The podiatrist destroyed the plantar common digital nerve with a neurolytic agent to treat the patient’s Morton’s neuroma. Should we report 64455 for this service or 64632?

Montana Subscriber

Answer: For the destruction of the plantar common digital nerve, such as with a Morton’s neuroma, you should report 64632 (Destruction by neurolytic agent; plantar common digital nerve), not 64455 (Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton’s neuroma)).

Morton’s neuroma defined: Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the third and fourth intermetatarsal spaces.

64632: With 64632, the podiatrist uses neurolysis to destroy the nerves that are responsible for carrying pain. This destruction includes the use of chemical, heat, or radiofrequency techniques.

64455: With 64455, the podiatrist injects a corticosteroid (such as triamcinolone, depo–medrol, or prednisone) or an anesthetic substance into the plantar common digital nerve for the treatment of Morton’s neuroma or other inflammatory nerve conditions.

Caution: You should never report 64455 in conjunction with 64632, according to CPT^® instruction.