Wiki 20550 and 64450 for plantar fasciitis

[jhofler]

Good Morning - I have a Doc who is billing for 20550 and 64450 for plantar fasciitis. I get an error message stating that 20550 has an unbundle relationship with 64450. I'm thinking that 20550 is sufficient enough without 64450 as it is a better description of the procedure and a modifier is not needed, but I'm not quite sure. Your assistance is appreciated, thanks!

 

[AlanPechacek]

The code 64450 is for Injection of an Anesthetic Agent (Novocaine type local anesthetic) for the purpose of a "Nerve Block," either diagnostic or therapeutic. When an injection is done for Plantar Fasciitis, it is not a "Nerve Block" (even though a local anesthetic is used along with a steroid for the injection), but an injection into the area of the heel where there is inflammation of the Plantar Fascia where it attaches to the Calcaneus (Heel Bone). Plantar Fasciitis is an inflammatory disease, not a neuropathy. Therefore, unless your physician is doing something really out of the ordinary for Plantar Fasciitis, 20550 should suffice alone.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com