Coding In 2007: What You Should Know

By Anthony Poggio, DPM

      As the calendar turns to 2007, podiatrists should be aware of the changes to reimbursement codes instituted by the Center for Medicare and Medicaid Services (CMS). Starting on January 1, there are a number of changes that will affect Medicare billing. Accordingly, let us take a closer look at key CPT/ICD-9 codes that are more pertinent to podiatry.

      There are a number of changes to the CPT codes that practitioners should know. There is no 90-day grace period for deleted codes as there had been in the past. New CPT codes are valid as of January 1, 2007.

      CPT 28055. This code is to resect a nerve in the foot (neurectomy, intrinsic musculature of foot). This code is for the excision of a motor nerve, not a sensory nerve. This will replace CPT 28030. One should still use CPT code 28080 for excision of a Morton’s neuroma.

      CPT 17110. Use this code for the destruction of benign lesions including verrucae. The code allows for the billing of one to 14 lesions as a group. One can no longer bill lesions individually. If you treat more than 15 lesions, use CPT 17111, which would be billed as a lump sum for more than 15 lesions. It is unclear at this time what the RVS value will be for the new code to allow for the destruction of multiple lesions.

      As of January 1, CPT code 28030 has been deleted for 2007 and replaced with CPT 28055.

      As of January 1, a few CPT codes will be revised. The skin care substitute codes themselves will not change but the clause that implies that surgical fixation is required for payment has been deleted. Specifically, as far as the 15XXX code series, there is no change in the codes per se but there is a change in the introduction portion, which clarifies the use of these codes. In the past, there was controversy as some skin substitutes did not require fixation per se. A change in the language deletes the term “surgical fixation.”

      CPT codes 17000–17004, which had been used to bill for destruction of “benign” lesions, including verrucae and pre-malignant lesions, have been revised to cover only the pre-malignant lesions. CPT 17000 is the code to use for laser, chemocautery, electrosurgery and cryotherapy. Currettement procedures would be best done with this procedure series. CPT 14200 would require surgical closure of the wound.

A Guide To Key ICD-9 Codes

      New ICD-9 codes were valid as of October 1, 2006. There is no longer a 90-day grace period as there has been in the past. The new codes for 2007 are listed below.

      277.30 Amyloidosis, unspecified
      284.1 Pancytopenia
      288.00 Neutropenia, unspecified
      288.03 Drug induced neutropenia
      288.04 Neutropenia due to infection
      288.09 Other neutropenia
      288.50 Leukocytopenia, unspecified
      288.51 Lymphocytopenia
      288.59 Other decreased WBC count
      288.60 Leukocytosis, unspecified
      288.61 Lymphocytosis (symptomatic)
      288.69 Other elevated WBC count
      333.94 Restless leg syndrome
      388.0 Central pain syndrome
      338.11 Acute pain due to trauma
      338.18 Other acute postoperative pain
      388.19 Other acute pain
      338.21 Chronic pain due to trauma
      338.28 Other chronic postoperative pain
      338.29 Other chronic pain
      338.3 Neoplasm related pain (acute) (chronic)
      338.4 Chronic pain syndrome
      729.72 Non-traumatic compartment syndrome of the lower extremity
      731.3 Major osseous defects
      780.96 Generalized pain
      958.90 Compartment syndrome, unspecified
      958.92 Traumatic compartment syndrome of lower extremity
      995.22 Unspecified adverse effects of anesthesia
      995.27 Other drug allergy
      995.29 Unspecified adverse effect of other drug, medicinal, and biological substance
      V58.30 Encounter for change or removal of non-surgical wound dressing
      V58.31 Encounter for change or removal of surgical wound dressing
      V58.32 Encounter for removal of sutures

What About Revised And Deleted ICD-9 Codes?

      These revised ICD-9 codes became valid after October 1, 2006:

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