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Anesthesia for Plantar Fascia

  1. Default Anesthesia for Plantar Fascia
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    I am new to Anesthesia coding and just need help on this - I couldn't find
    the LCD on the Medicare website.
    Can someone tell me if CPT 01464-AA is billable with Diag 728.71?

    GHI is denying the claim, stating the "Diag does not match the procedure".
    (If patient has plantar pain, can the anesthesia be applied to the ankle - or
    should the anesthesia have been injected directly into the foot?)

    Please advise...


  2. #2
    It might more be that you're billing an arthroscopic procedure code (joint) with a fascia disorder diagnosis code and GHI doesn't like the combination. I don't believe it's an LCD issue.

    Please give a description of the surgery you are providing anesthesia for and maybe I can help you refine your coding.

    Julie, CPC

  3. Default
    Are you coding for anesthesia services for a surgical procedure, or are you coding for pain management (an injection at the anatomical site) ?

  4. Default
    We are billing only for Anesthesia (by our Anesthesiologist) for a surgical procedure (performed by a surgeon). We are not billing for the surgical procedure itself.

    Thank you,


  5. Default

    The CPT code for the surgery is 29893, which is the surgeon's bill - separate from our Anesthesia CPT of 01464-AA.

  6. #6
    So this was an arthroscopic plantar fasciotomy..... If so, your coding is correct. I'm not sure what state you're billing for but I looked up GHI/NGS Medicare and could not find an active LCD either. So then my next question is was the surgeon and MD or a podiatrist? Is the Medicare carrier inappropriately considering this foot care? Also, I would call the surgeon's office and get their diagnosis codes and confirm they have been paid -- chances are they are aware of an LCD if it exists and it could be as simple as adding another diagnosis. If they've been paid and your diagnosis matches then I'd call Medicare for the clarification and basis of the denial.

    I'm sorry I don't have a good answer but if you come accross more information I'd be more than happy to hash it out with you.

    Julie, CPC
    Last edited by jdrueppel; 06-24-2009 at 10:29 PM.

  7. #7
    Jamaica, NY
    ** I am having the same issue with GH & Hip constantly denying these codes together this year- never a problem in years past ** I can't find an LCD either. We have just been sending the report along w/ copies of the cpt & Icd 9 book as proof that they go together- The only thing I can think of is to look at code 28008 which maps to 01470. Query the podiatrist as to what procedure they are performing (maybe it wasn't done endoscopically)- If your Anesthesia Doc's are like mine, they become lazy and just write the same description over & over, especially if the Podiatrist is doing a few cases in a row.

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