With ICD-10 coding, documentation of clinical information will get better documented, especially regarding the patient’s health condition. Further, ICD-9 had only 13000 codes and could not keep up with the newly developed procedures and advances in medical technologies. The ICD-10 coding system introduces 68,000 codes. In podiatry coding, nearly one-third of the ICD-10 codes match the ICD-9 codes, and the exception is the introduction of laterality or if the right or left side of the anatomy has been affected. Moreover, the data now documented includes:
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An initial encounter, a subsequent encounter
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Acute or chronic
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Anatomical side of the limbs
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Different stages of healing or unhealed- normal, delayed, non-union or malunion
Certain changes to be aware of when employing the ICD-10 coding for Podiatry, which will affect podiatry billing and thereby revenues, with respect to specific areas are:
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Terminology- certain medical terminology to reflect certain medical conditions are now more specific in the ICD-10-CM coding as against the ICD-9-CM coding
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Infections resistant to antibiotics require additional coding
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Diseases that affect the Musculoskeletal system and connective tissue now have site and laterality designations that have specific codes to be employed when documenting
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Use of Anatomic Modifiers for podiatric procedures is very essential for reimbursement. If a procedure is billed that may require bilateral procedures, and if later in time you bill for the other side, your claim may be denied if you had not mentioned the anatomical site in the previous billing. Thus it is very important to append the proper Anatomic Modifier to CPT codes on claims when required to avoid unnecessary denials
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Type and state of encounter also needs to be well documented so that coders capture the real scenario
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Medicare compliance: Since podiatrists diagnose and treat foot, ankle, leg and lower back, coders are required to be aware of the specific anatomical information. It should be noted that Medicare does not cover treatment of orthotics or flat feet as separate procedures, unless for example the expense includes a leg brace or the patient has diabetics for the use of therapeutic shoes.
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Medicare covers debridement based on certain conditions which requires the presence of a systemic condition and the care of a professional. Debridement should be reported by physicians in their documentation if coders are to bill for such visits.
Some of the top 10 podiatry ICD-9 to ICD-10 codes that coders and billers need to pay attention to which have further expansion codes and require physician’s crucial documentation are:
|
ICD-9CM |
ICD-9CM Description |
ICD-10CM |
ICD-10CM Description |
|
782.3 |
Edema |
R60.9 |
Edema |
|
726.73 |
Calcaneal spur |
M77.30 |
Calcaneal spur |
|
734 |
Flat foot |
M21.40 |
Flat foot |
|
703.0 |
Ingrowing nail |
L60.0 |
Ingrowing nail |
|
735.0 |
Hallux valgus(acquired) |
M20.10 |
Hallux valgus (acquired), unspecified foot |
|
729.5 |
Pain in limb |
M79.609 |
Pain in unspecified limb |
|
735.5 |
Claw toe (acquired) |
M20.5X9 |
Other deformities of toe(s) (acquired), unspecified foot |
|
078.12 |
Plantar wart |
B07.0 |
Plantar wart |
|
754.61 |
Flat foot, congenital |
Q66.50 |
Congenital pes planus, unspecified foot |
|
700 |
Corns and callosities |
L84 |
Corns and callosities |
Thus if physicians along with coders and billers are to bring in the added reimbursements given the changing healthcare reforms and ICD coding transition, then putting their best foot forward using detailed clinical documentation, is the way to go!
Published By - Medical Billers and Coders
Published Date - Sep-15-2015
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