Podiatry Coding & Billing Alert
Test Your Achilles Tendinitis Smarts With a Quick Quiz
Learn the 2 types of Achilles tendinitis. Coding all the different diagnoses you see in your podiatry practice every day can be tricky. Not only does ICD-10-CM offer multiple, specific codes to choose from, but you must also understand the intricacies of different diagnoses, such as Achilles tendinitis. For example, when you report Achilles tendinitis, you must ensure you are not confusing Achilles tendinitis with peroneal tendonitis. Read on to learn more. First, Define Achilles Tendinitis for Clarity Question: What is Achilles tendinitis? Achilles tendinitis is degeneration or injury to the Achilles (calcaneal) tendon, the tendon that attaches the calf muscle to lower leg to the ankle bone. Tendinitis is defined as inflammation or irritation of a tendon, in this case, the Achilles tendon. Achilles tendinitis is most often caused by overuse or repetitive stress to the tendon. Athletes such as runners are typical Achilles tendinitis patients. Other typical patients include those with bone spurs, which is “extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain,” according to the American Academy of Orthopaedic Surgeons (AAOS). Differentiate Between 2 Types of Achilles Tendinitis Question: How many types of Achilles tendinitis are there? Answer: There are two types of Achilles tendinitis, according to the AAOS. These include non-insertional Achilles tendinitis and insertional Achilles tendinitis. Non-insertional Achilles tendinitis defined: When a patient has non-insertional Achilles tendinitis, the fibers in the middle section of the Achilles tendon degenerate, swell, and thicken. This type of tendinitis is common in young, active patients, per the AAOS. Insertional Achilles tendinitis defined: On the other hand, insertional Achilles tendinitis involves the lower part of the patient’s heel where the Achilles tendon attaches to the heel bone. This type of tendinitis can occur anytime even in non-active patients. However, long distance runners and sprinters are among the common type of people impacted by this type. “Make sure you differentiate between Achilles tendinitis and peroneal tendonitis since many of the symptoms are the same,” says Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan. “The difference often that peroneal tendon causes pain and swelling along the lateral aspect of the foot running to the base of the fifth metatarsal.” Focus on Achilles Tendinitis ICD-10-CM Codes Question: What ICD-10-CM choices do I have for Achilles tendinitis? Answer: The ICD-10-CM codes you should report for Achilles tendinitis are the following, depending on the encounter specifics: Pinpoint Achilles Tendinitis Symptoms Question: What are some symptoms of Achilles tendinitis? Answer: Symptoms of Achilles tendinitis include pain and stiffness along the Achilles tendon, pain along the Achilles tendon or back of the heel that worsens with activity, severe pain after exercising, thickening of the tendon, and bone spurs. Learn Nonsurgical Treatment Options Question: What are the nonsurgical treatment options for Achilles tendinitis? Answer: Nonsurgical treatment options for Achilles tendinitis include resting, icing the tendon, non-steroidal anti-inflammatory medication, stretching, and physical therapy. Don’t Mix Up Achilles Tendinitis With Peroneal Tendonitis Question: My podiatrist documented a diagnosis of peroneal tendonitis. Does this differ from Achilles tendinitis? Which ICD-10-CM codes should I look to for peroneal tendonitis? Answer: Yes. Peroneal tendonitis differs from Achilles tendinitis, and you have different codes to choose from for this diagnosis. Peroneal tendonitis defined: The two peroneal tendons run parallel along the outer ankle bone. When a patient has peroneal tendonitis, his peroneal tendons become inflamed, which occurs when there is an increased load and overuse of the tendons, leading to them rubbing on the bone. This friction causes the tendons to swell. Over time, the tendons will thicken in size to try and manage the increased load more efficiently. Symptoms: Common symptoms of peroneal tendonitis include the following: ICD-10-CM codes: You should report peroneal tendinitis with the following ICD-10-CM codes, depending on encounter specifics: 
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