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Tip: Understand the procedures that treat plantar fasciitis

Ambulatory Surgery Reimbursement Update, July 15, 2008

Plantar fasciitis is an inflammatory condition of the plantar fascia on the bottom of the foot, and it can be quite painful. It is sometimes referred to as "flip-flop disease" by podiatrists. This condition can be caused by a patient who has abnormal pronation of the foot when they walk and is manifested by pain on the bottom of the foot, usually in the heel area. It is usually more intense when arising from bed for the day. It can also be caused by excessive weight-bearing, excess walking on hard surfaces, obesity, poor shoe gear, and inactivity. Sometimes it is associated with heel spurs. The diagnosis code for plantar fasciitis is code 728.71 for plantar fascial fibromatosis.

Procedures used to treat plantar fasciitis include:

• Injection of steroids or pain medicine into the plantar fascia (code 20550)
• Fasciotomy of the foot, which is also known as a percutaneous plantar release (code 28008)
• Fasciotomy of the foot performed endoscopically, known as an endoscopic plantar fasciotomy (code 29893)
• The more extensive plantar fasciectomy procedure has two codes (code 28060 for a partial procedure or 28062 for a radical procedure—when one-third or more of the fascia is removed). These codes are considered separate procedures, and they may be unbundled from other procedures performed during the same surgical session. If a physician performs the procedure in a separate area from a code from which it is listed as unbundled, append a modifier -59 and bill it separately.
• Extracorporeal shock wave therapy of the plantar fascia performed under anesthesia other than local (code 28890)

This tip is brought to you by Ellis Medical Consulting, Inc.

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