Foot and ankle injuries are among the most common musculoskeletal injuries which make millions of Americans visit their local podiatrist’s office each year. Injuries to the foot and ankle are normally caused by stress and repetitive play. These types of injuries are quite common among people who play football, basketball, soccer, and running where the feet are the point of contact. About 75 percent of people in the United States suffer from foot problems at some point in their lives. Plantar fasciitis is one such common foot and ankle injury. One of the most common causes of heel pain, plantar fasciitis involves inflammation of a thick band of (also called a fascia) at the bottom of your foot that runs from your heel to your toes. According to recent estimates, approximately 2 million patients are treated for this condition in the US every year. Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. Treatment for this condition involves a combination of resting, medications and physical therapy exercises. Podiatrists work together with other physicians or specialists to repair fascia injury. Providers can rely on a podiatry medical billing expert to submit accurate claims and get reimbursed for their services.
Plantar fasciitis is more common in runners. In addition, people who are overweight and those who wear shoes with inadequate support also have an increased risk of developing this condition. Normally, your plantar fascia is in the shape of a bowstring, supporting the arch of your foot and absorbing shock when you walk. When repeated stress occurs on the bowstring, small tears tend to develop in the fascia. Other additional factors that can increase your risk of developing this condition include – age, foot mechanics, certain types of exercise and occupations that keep you on your feet.
Symptoms, Diagnosis and Treatment Options for Plantar Fasciitis
A stabbing pain in the bottom of your foot near the heel is one of the initial symptoms of this condition. The pain usually gets worse when you take the first steps in the morning or can also be triggered by long periods of standing or when you get up after sitting. The pain is usually worse after exercise, not during it. Although many people with plantar fasciitis tend to have heel spurs, spurs are not the cause of plantar fasciitis pain. In fact, 1 out of 10 people have heel spurs, but only 1 out of 20 people (5%) with heel spurs have foot pain. As the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.
Diagnosis of this condition may begin with a physical examination and detailed medical history review. As part of the physical exam, the physician may check for areas of tenderness on the bottom of your foot, just in front of your heel bone. Physicians may normally look for signs like a high arch, worsening pain (when you flex your foot) and limited “up” motion of your ankle. Podiatrists may recommend imaging tests like X-ray, magnetic resonance imaging (MRI) and ultrasound to make sure another problem, such as a stress fracture, is not causing you pain.
Treatment modalities for this condition may generally include – medications (pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), steroid injections, resting and icing the painful area. Physical therapy exercises can help ease the pain and inflammation. Patients may also be advised to wear night splints and custom-fitted arch supports (orthotics) to distribute pressure across the affected foot more evenly. Avoiding activities that put additional strain on the foot and wearing proper shoes may help prevent the condition in the long run.
Podiatrists and other orthopedic specialists who treat plantar fasciitis injury must use the relevant medical codes to bill for the procedure. The medical codes used to report plantar fasciitis injury include –
ICD-10 Codes
- M72 – Fibroblastic disorders
- M72.0 – Palmar fascial fibromatosis [Dupuytren]
- M72.1 – Knuckle pads
- M72.2 – Plantar fascial fibromatosis
- M72.4 – Pseudosarcomatous fibromatosis
- M72.6 – Necrotizing fasciitis
- M72.8 – Other fibroblastic disorders
- M72.9 – Fibroblastic disorder, unspecified
CPT Codes
- 0232T – Injection(s), platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed
- 0481T – Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed
- 20552 -Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)
- 20553 -Injection(s); single or multiple trigger point(s), 3 or more muscle(s)
- 28890 – Extracorporeal shock wave, high energy, performed by a physician or other qualified healthcare professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia
- 28008 – Fasciotomy, foot and/or toe
- 28060 – Fasciectomy, plantar fascia; partial (separate procedure)
- 28062 – Fasciectomy, plantar fascia; radical (separate procedure)
- 28250 – Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure)
To prevent the occurrence of heel pain that arise as part of plantar fasciitis, it is important to make several lifestyle changes. These include – maintaining a healthy body weight, choosing supportive shoes, stretching your arches, not wearing worn-out athletic shoes, applying ice, and getting engaged in low impact sports activities.
Knowing the highly specific medical codes related to repairing plantar fasciitis is critical for providers. Partnering with an experienced medical billing and coding company is a great option for physicians to ensure accurate and timely claim submissions.
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