Podiatry focuses on diagnosing and treating foot wounds and deformities. It includes diagnosing and treating foot, ankle, and lower extremity problems medically and surgically. In addition to medical and surgical procedures, mechanical and physical therapies are available. Podiatry, like other disciplines, relies on consistent collections to stay in business.
Coding in podiatry, on the other hand, is difficult because different procedures are performed on the same structure or organ, necessitating different codes. This guidance has long been followed by several third-party payers, including Medicare, and it applies to all CPT codes, regardless of payer.
This guidance is consistent regardless of where you receive your services. The CPT code representing the cast application should not be submitted if the triple arthrodesis is performed in the operating room.
Podiatry CPT Coding changes for 2022
In 2022, the CPT clarified the following codes for external fixation:
"External fixation codes are reported separately only when external fixation is not listed as inherent to the procedure in the code descriptor."
As a result, providers can only submit CPT codes for external fixation. CPT does not include the use of external fixation in its primary procedure code descriptor.
The CPT code for a first metatarsophalangeal joint arthrodesis is as follows:
CPT 28750—Arthrodesis, great toe; metatarsophalangeal joint
External fixation is not included in the list of code descriptors. As a result, if external fixation is used, both the CPT code for the first metatarsophalangeal joint arthrodesis and the CPT code for the external fixation can be submitted.
The CPT code for the external fixation in the case of an open reduction and internal fixation (ORIF) of a metatarsal fracture would be:
CPT 28485—Open treatment of metatarsal fracture, with or without internal or external fixation
This is mentioned in the code descriptor. Thus, if external fixation is used with this procedure, only the ORIF CPT code can be submitted; the external fixation CPT code cannot be submitted as well.
Foreign Body vs Implant
Is it considered a foreign body removal if a joint prosthesis becomes loose or stops working? The CPT provides a clear answer to this long-asked question.
According to the new language on page 525 of the 2022 CPT book, it states:
"An implant is defined as any object that is intentionally placed by a physician or other qualified health care professional for any purpose (e.g., diagnostic or therapeutic)."
"A foreign body is defined as an object that is unintentionally placed (for example, trauma or ingestion)."
"Unless CPT coding instructions direct otherwise or a specific CPT code exists to describe the removal of that broken/moved implant, an implant (or part thereof) qualifies as a foreign body for coding purposes if it has moved from its original position or is structurally broken and no longer serves its intended purpose or presents a hazard to the patient."
In 2022, a new language requires only one CPT code to represent the closure of a single wound when multiple products and/or techniques are used to close it.
More information on wound repair can be found on page 106 of the 2022 CPT book, where it is stated that wounds treated with chemical cauterization, electrocauterization, or adhesive strips cannot be coded with wound repair CPT codes.
More information on wound repair can be found on page 106 of the 2022 CPT book, where it is stated that wounds treated with chemical cauterization, electrocauterization, or adhesive strips cannot be coded with wound repair CPT codes. priority is the clarification of simple wound repair:
"Simple repair is used when the wound is superficial (eg, primarily epidermis or dermis, or subcutaneous tissues with little involvement of deeper structures) and requires simple one-layer closure."
Furthermore, anesthesia and hemostasis should not be reported separately when treating superficial wounds.
These are just a few changes relevant to podiatrist practices in 2022’s CPT codes. The podiatry providers who submit CPT codes should know the entire CPT code set or use experts who are familiar with it.