Podiatry Coding & Billing Alert

Remember: Heel spurs are also known as calcaneal spurs.

If your podiatrist performs surgery to treat heel spurs, you must check the medical documentation for numerous details including if your podiatrist removed part of the calcaneus during the surgery. Additionally, if your podiatrist also applied a cast during the procedure, you must know the global period rules.

Keep these tips in mind when reporting heel spur claims in your podiatry practice.

Tip 1: Discover Heel Spur Surgery Options

If your podiatrist performs surgery for a heel spur, you have three different CPT^® codes to choose from.

Code 28118: If your podiatrist excises a heel spur and removes a part of the calcaneus, you should report 28118 (Ostectomy, calcaneus).

Code 28119: If your podiatrist performs an ostectomy, calcaneus for spur with or without a fascial release to excise the spur, you should report 28119 (Ostectomy, calcaneus; for spur, with or without plantar fascial release). You should report 28119 regardless of whether your podiatrist made release incisions on the stressed or irritated plantar fascia. You should also check the operative note to confirm any fasciotomy your podiatrist performed.

Ostectomy: An ostectomy is defined as surgical removal of all or part of a bone.

Code 20551: If your podiatrist gives the patient a corticosteroid injection in his foot that includes both the plantar fascia and the area around the heel spur to reduce inflammation, you should report 20551 (Injection(s); single tendon origin/insertion) for the injection, along with the appropriate J codes for the medication.

Tip 2: Report These ICD-10-CM Codes for Heel Spurs

If your podiatrist diagnoses a patient with a heel spur, you should look to the following ICD-10-CM codes:

• M77.30 (Calcaneal spur, unspecified foot)
• M77.31 (Calcaneal spur, right foot)
• M77.32 (Calcaneal spur, left foot).

Heel spurs defined: Heel spurs are also known as calcaneal spurs. Heel spurs may be caused by tears in the origin of the plantar fascia at the calcaneus. The plantar fascia may tear at its origin on the heel bone because of excessive use or microtrauma. If the tear does not heal completely, calcium deposits can form an exostosis or protrusion, creating a heel spur.

Tip 3: Don’t Forget to Report Cast Application

In some cases, when your podiatrist performs a heel spur excision, he may also apply a walking cast at the time of the surgery. The first cast your podiatrist applies at the time of the surgery is part of the global surgery. However, you may report subsequent casts, if any. For example, if your podiatrist applies a short leg cast, you can report 29405 (Application of short leg cast (below knee to toes)).

Don’t miss: If your podiatrist changes a cast during a global period, there must be a medical cause for the change.

Example: Your podiatrist must change a patient’s cast because of a stage 1 pressure ulcer on her right heel. On your claim, you should report 29405 and append modifier 58 (Staged or related procedure or service by the same physician during the postoperative period). For the ICD-10-CM code, you should report L89.611 (Pressure ulcer of right heel, stage 1).