Tackle Turf Toe Injury Coding With These Tips – Part 1
Find out what codes to report for turf toe diagnoses. Turf toe is a painful injury that is common among athletes. The condition affects the metatarsophalangeal (MTP) joint and plantar plate ligament in the foot. As a podiatry coder, you should familiarize yourself with the injury, diagnostic process, and treatment procedures, so you can accurately code cases as they enter your workflow. In this first part of a two-part series, you’ll learn about turf toe and understand the correct ICD-10-CM codes. Get to Know the Injury Turf toe is a sprain of the plantar plate ligament, located at the base of the first joint of the big toe. This injury is prevalent in athletes participating in sports that involve repetitive pushing off from the ground, such as soccer, football, and basketball. The primary cause is hyperextension of the MTP joint, which exerts pressure and stress on the plantar plate ligament. This can result from a single forceful impact or jolt or repetitive strain over time. Symptoms of turf toe, like many ligament injuries, can include immediate pain in the affected area, accompanied by swelling, tenderness, and stiffness that may limit range of motion. Without proper treatment, even mild injuries can persist and worsen, necessitating medical evaluation. Visualize the Injury to Definitively Diagnose Turf Toe Diagnosing turf toe involves a physical examination by a podiatrist or other healthcare professional, who will assess the injury and activity leading up to the injury. The provider may order imaging studies, such as X-rays or MRI, to evaluate the extent of the damage. X-rays are captured to rule out bone fractures or joint misalignment, and MRI provides a detailed visualization of soft tissues, such as ligaments and tendons, to assess the severity of the sprain. Treatment varies based on the injury’s severity but typically includes the RICE method (rest, ice, compression, and elevation). Nonsurgical treatments for grade 1 and 2 injuries include: Grade 3 injuries or conditions with persistent issues may require surgical treatment. The podiatrist may view surgery as necessary for a complete ligament tear or significant joint instability. Dive Into Diagnosis Coding for Turf Toe Injuries ICD-10-CM codes for turf toe, or a sprain of the great toe’s MTP joint, fall under the S93.5- (Sprain of toe) code range. The code for turf toe specifies the MTP joint that has been affected and it must designate which toe (right, left, or unspecified) and include the encounter type (initial, subsequent, or sequela), so detailed documentation is crucial for accurate billing. Under the S93.5- code subcategory, you’ll find turf toe ICD-10-CM codes. Specifically, the S93.52- (Sprain of metatarsophalangeal joint of toe) subcategory specifies a sprain of the MTP joint of the toe. Other details you need to consider for turf toe coding include: To assign the most accurate code, you must add characters to the base code to specify the foot (right/left) and encounter type. Below are examples of complete codes for turf toe diagnoses: Next month, Revenue Cycle Insider will break down the different CPT® codes you can use to report surgical and nonsurgical treatment procedures. Jessica Sullivan, CPC, COSC, COBGC, Consultant,
Professional Audit, Coding & Education Services (PACE)
