Member’s Tip: Pain-free Coding of Morton’s Neuroma
- By admin aapc
- In Coding
- October 5, 2009
- Comments Off on Member’s Tip: Pain-free Coding of Morton’s Neuroma
Submitted by Rebecca Woodward, CPC, CEMC
In the past, there was some confusion on how to properly code Morton’s neuroma, but two newly-created CPT® codes make coding this condition much less of a pain in the … foot.
A Morton’s neuroma is a benign growth on nerve tissue that occurs in the nerve of your foot, often between the third and fourth toes, although it also may occur at the second toe interspace. Symptoms can range from burning, numbness, and tingling, to sharp pains in the sole of your foot. A Morton’s neuroma can develop from tight fitting shoes, injuries, and other pressuring irritants.
Report unilateral CPT® code 64455 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton’s neuroma) for the steroidal and/or anesthetic agent injections used for pain relief, or 64632 Destruction by neurolytic agent; plantar common digital nerve for the nerve destruction by a neurolytic agent.
Report either 64455 or 64632 only once per foot, regardless of the number of injections provided. When either of these services is performed on both feet, you may append modifier 50 Bilateral procedure to either code.
CPT® 28080 Excision, interdigital (Morton) neuroma, single, each describes the surgical excision of the Morton’s neuroma. Report this code for each neuroma excised.
CPT® instructs you to use 77003 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedure (epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve, or sacroiliac joint), including neurolytic agent destruction for fluoroscopic guidance and localization for needle placement and injection. Report this code only once per session, regardless of the number of injections.
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CPT instructs to report 77003 — which, as the descriptor above clearly states, is for spinal injection guidance — with codes 64622-64627, not 64632.
Just want to point out that CPT 77003 is used only for spine injection procedures. The appropriate CPT for fluoro used in podiatry injections is 77002.
77003 was not referenced in the article submitted. I’m not sure how or why this code was linked to this article.
Rebecca Woodward CPC, CEMC
I searched for “excision of Neuroma RT/2nd interspace” and landed here. The doctor did an excision of Neuroma 2nd interspace. The two codes that come up are 28080 and 64774. Not sure which bests describes the procedure because it is the 2nd interspace