The foot is a complex and intricate part of the human body. Did you know, your foot has 26 bones, 33 joints, 107 ligaments and 19 muscles? Our feet, in general, are one of the most used and abused parts of our bodies. They are our natural shock absorbers, with each foot taking on approximately one and a half times your body weight while you walk. We often add to the punishment by wearing ill-fitting shoes and not maintaining a healthy weight. So many things can go wrong with either one or both feet, causing significant pain, and deformities, affecting the way you walk and possibly cause injury to your hips and spine. Common foot problems include hammertoes, bunions and osteoarthritis. There are many non-surgical ways to try to remedy common causes of foot pain, such as orthotics, anti-inflammatory medications, etc. However, very often, surgical intervention is needed.
Anyone who has coded or attempted to code for procedures on the foot and toes has no doubt discovered the complexities of the CPT codes. It’s impossible to code for them without a thorough understanding of foot and toe anatomy. Additionally, many providers refer to these procedures by eponyms which can confuse when it comes to code selection. The eponyms often refer to techniques and types of cuts made rather than the actual structures corrected. For example, how would you code a Scarf osteotomy? A scarf osteotomy is a description of the shape of the bone cut. This eponym does not tell us which bone is affected. Correct code selection depends on identifying the affected bone.
Lastly, it can also be challenging to decide which procedures may be reported separately. There are many procedures that, when performed, are included in the main procedure term. Often providers don’t understand this concept and may push to unbundle everything. Being confident in what you can and can’t code together will help you to educate your surgeon. A useful resource for some is the CMS NCCI Manual, Chapter 4.
If you would like to have a better understanding of CPT coding for procedures of the foot toes, join our May webinar, CPT Coding for Hammer Toes and Bunionectomies, where we break down these procedures into an easy to understand format. We will examine the anatomy, terminology and bundled procedures.
Deanna Upston, CPMA, CPC, COSC
Deanna is a consultant for The Haugen Consulting Group with over 20 years of health care industry experience. Her introduction was through medical assisting, which she enjoyed for several years. Once she was established at a surgeon’s office, she started coding their surgical cases and discovered that was her favorite part of the day. Deanna has experience working on the professional fee side of coding, audit, education and compliance serving coders and physicians. She has put together multiple education sessions for both provider and coder. She also has experience working as an analyst in which she validated the integrity of editing logic during the implementation of claim scrubbing software.