Podiatry Coding & Billing Alert

Code M72.2 not blanket code that covers any condition associated with the plantar fascia.

Baseball season is coming up, which means podiatrists will start seeing some of the common injuries that athletes experience. Do you know what ICD-10 codes to turn to when the podiatrist documents Morton’s neuroma, plantar fasciitis, and a foot fracture? Make sure you learn the rules for reporting these injuries to always submit clean claims in your practice.

Read on to learn more.

Spotlight Codes for Morton’s Neuroma

Baseball players may get Morton’s neuroma because this condition can be caused by playing sports or wearing shoes with a narrow toe box. “All types of patients can get neuromas,” says Jordan Meyers, DPM, partner at Raleigh Foot and Ankle Center and consultant at Treace Medical Concepts, Inc. in Raleigh, North Carolina. “It just depends on the anatomy of the foot, the type of activity, and tighter shoegear.”

Morton’s neuroma defined: Morton’s neuroma is sustained irritation or inflammation causing perineural fibrosis and thickening of the communicating branch between the medial and lateral plantar nerves in the third interspace between the third and fourth metatarsals.

Symptoms of Morton’s neuroma can include numbness, burning, and tingling radiating into the toes towards the middle part of the foot, Meyers says. Morton’s neuroma can also feel like a “lump” in the foot or a “balled up sock” around the patient’s toes.

ICD-10 codes: You can rely on the following ICD-10 codes for Morton’s neuroma:

• G57.60 (Lesion of plantar nerve, unspecified lower limb)
• G57.61 (Lesion of plantar nerve, right lower limb)
• G57.62 (Lesion of plantar nerve, left lower limb)
• G57.63 (Lesion of plantar nerve, bilateral lower limbs)

Pinpoint Correct Plantar Fasciitis Code

Another common foot ailment for baseball players is plantar fasciitis. This condition results in heel pain, stiffness, and inflammation, making walking more difficult for the patient.

Plantar fasciitis is the inflammation of the plantar fascia, which is a thick aponeurosis that supports the arch on the bottom (plantar side) of the foot. When your podiatrist diagnoses a patient with plantar fasciitis, you should report M72.2 (Plantar fascial fibromatosis). If you look in the ICD-10 manual, you will notice that plantar fasciitis is an included diagnosis for M72.2.

Don’t miss: Always Code M72.2 is not a blanket code that covers any condition that may be associated with the plantar fascia. read the medical record carefully to make sure you understand exactly which diagnosis your podiatrist documented.

Treatment options: According to experts, initial treatment for plantar fasciitis should not be surgery. The podiatrist should attempt more conservative means to alleviate the condition first. Some of the more conservative treatments for plantar fasciitis include the following:

• Rest
• Ice
• Foot stretching
• Nonsteroidal anti-inflammatory drugs (NSAIDS)
• Physical therapy
• Shoe inserts
• Use of stretching boots

Identify Open or Closed for Foot Fracture

Foot fractures are also common injuries that a baseball player might experience.

Coding example: A baseball player visits the podiatrist for an open, displaced traumatic fracture of the fifth metatarsal bone on his right foot that he sustained while sliding into home plate. You should report S92.351B (Displaced fracture of fifth metatarsal bone, right foot, initial encounter for open fracture) for this injury.

Don’t miss: A closed fracture involves a bone break that has not penetrated the skin. So, if there is no evidence of a breach of the skin in the encounter notes, you likely have a closed fracture claim on your hands.

Conversely, “an open fracture is when the bone has punctured through the skin or there is a significant break in the skin directly over the fracture site - not an abrasion or superficial laceration,” says Sharon Richardson, compliance officer of EM Services at Emergency Groups’ Office in San Dimas, California.

Also, for a displaced fracture, the bone snaps in two or more places and moves so that the two ends are not in their normal alignment.

On the other hand, in a non-displaced fracture, the bone cracks either part or all of the way through, but it maintains its proper alignment and has not moved from its normal position.

Discover Appropriate Bunion Dx Code for This Scenario

A baseball player comes into the podiatrist’s office, and the podiatrist diagnoses him with a bunion on his left foot. “A bunion is enlargement of the bone on the medial and/or dorsal aspect of the first metatarsal bone,” explains Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan. You would report M21.612 (Bunion of left foot) for this condition.

Wearing tight, narrow shoes can cause or exacerbate bunions. Some non-surgical treatment options for bunions including wearing shoes that are wide enough and using shoe inserts.

Mark Down This Option for Achilles Tendon Rupture

A baseball player comes into the podiatrist’s office with a left Achilles tendon rupture. This is an initial encounter. You should report S86.012A (Strain of left Achilles tendon, initial encounter) for this injury

Achilles tendon rupture defined: The Achilles tendon, the largest tendon in the body, connects the calf muscles to the heel bone (calcaneous). Athletes can rupture their Achilles tendon when they put too much strenuous force on it.

The most common symptoms of an Achilles rupture include “pain and swelling at or near the heel. Any stretching of the site will be painful, such as bending forward, or pushing off; going on tip toes should be impossible or cause extreme pain,” says Chelle Johnson, CPMA, CPC, CPCO, CPPM, CEMC, AAPC Fellow, staff services coordinator/billing/credentialing/auditing/ coding at County of Stanislaus Health Services Agency in Modesto, California. Some patients will also describe a “popping” sound at the time of the injury and immediate sharp pain.