When was the last time you really thought about the marvel that is your foot?  The human foot is composed of 26 bones, 33 joints, and what seems like endless tendons and ligaments.  The number of body parts alone make coding podiatric procedures complex.  And much like Paul Simon’s claim that there are 50 ways to leave your lover, there seems to also be 50 ways to amputate a foot.

Understanding foot amputation coding begins with a thorough review of foot anatomy.  The foot is made up of bone groups:

  • 14 phalangeal (toe) bones
  • 5 metatarsals
  • 7 tarsals

Each of those bones are connected by a network of joints with their own special acronym language.  Since podiatric operative reports look like alphabet soup, it’s important to brush up on your medical terminology shorthand.  Some common examples include:

  • MTP: metatarsophalangeal
  • TMT: tarsometatarsal
  • DIP: distal interphalangeal
  • PIP: proximal interphalangeal

ICD-10-PCS qualifiers for foot amputations refer to rays.  A ray includes each metatarsal bone along with its attached phalanx.  When an entire metatarsal bone is removed by disarticulating at the TMT joint (between the tarsal bone and metatarsal), it is referred to as a complete detachment.  Cutting through a portion of the metatarsal bone using a bone saw is a partial detachment.

Just when you have the anatomy and terminology straight, the surgeon may throw you a curve ball and begin talking about foot regions.  There are three regions in the foot and amputations can occur anywhere along these bones.

  • Forefoot: metatarsals and phalanges
  • Midfoot: cuboid, navicular, and medial, intermediate, and lateral cuneiforms
  • Hindfoot: talus and calcaneus

If you want to learn more about ICD-10-PCS coding for amputations and other foot procedures, tune in on May 21, 2020! Webinar will be available on-demand for viewing and CEUs after 5.21.20.

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

Senior Consultant

Kristi is a senior consultant with more than 20 years of industry experience. She develops and delivers training on ICD-10-CM/PCS and CPT, both virtually and in classroom settings.
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.

2 Comments

  1. Arthur L. Bolen II

    Hello,
    I am a student studying coding and I am curious as to how to code a detachment of a foot between the tibia/fibula and the metatarsals. I am aware that “complete” is the term used for detachment of the foot containing the metatarsals and all parts of the rays. I would love to watch the presentation that went with this site, but unfortunately, I am four months too late.
    If there is a link or a copy of your presentation available I would greatly appreciate it.

    Sincerely,
    Art Bolen

    Reply
    • kkluglein

      Hi Art,
      Thank you so much for reading our blog! All of our webinar presentations are recorded live, but you can purchase access to the recorded event after it is recorded. This particular webinar is eligible for CEUs until 5.31.21 and the recording will be available until 5.31.22. You can purchase it here: https://www.thehaugengroup.com/marketplace/ha-marketplace/icd-10-pcs-for-podiatry/. If you have any additional questions after watching the presentation, we can pass them along to our education team.
      Have a great day!

      Reply

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