Podiatry Services Codes

[Pages:26]INDIANA HEALTH COVERAGE PROGRAMS

PROVIDER CODE TABLES

Podiatry Services Codes

Note: Due to possible changes in Indiana Health Coverage Programs (IHCP) policy or national coding updates, inclusion of a code on the code tables does not necessarily indicate current coverage. See IHCP Banner Pages, IHCP Bulletins and IHCP Fee Schedules for updates to coding, coverage and benefit information.

For information about using these code tables, see the Podiatry Services provider reference module.

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Table 2 ? Procedure Codes for Routine Foot Care Table 3 ? ICD-10 Diagnosis Codes for Routine Foot Care Coverage Table 4 ? Procedure Codes for Orthotics for Severe Diabetic Foot Disease

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140)

Reviewed/Updated: May 3, 2023

Procedure Code 10060 10061 10140 10160 11000 11001 11042 11043 11044 11045 11046 11047 11055 11056 11057 11102 11103

Description Drainage of abscess Drainage of multiple abscess Drainage of blood or fluid accumulation Aspiration of abscess, blood accumulation, blister, or cyst Removal of inflamed or infected skin, up to 10% of body surface Removal of inflamed or infected skin Removal of skin and tissue first 20 sq cm or less Removal of skin and/or muscle first 20 sq cm or less Removal of skin and bone first 20 sq cm or less Removal of skin and tissue Removal of skin and/or muscle Removal of skin and bone Removal of single thickened skin growth Removal of 2 to 4 thickened skin growths Removal of more than 4 thickened skin growths Tangential biopsy of single skin lesion Tangential biopsy of additional skin lesion

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 11104 11105 11106 11107 11305 11306

11307 11308 11420 11421 11422 11423 11424 11426 11719 11720 11721 11730 11732 11740 11750 11755 11760 11765 12001

12002

12020 12041 13160 14040

14041

14350 15002

Description Punch biopsy of single skin lesion Punch biopsy of additional skin lesion Incisional biopsy of single skin lesion Incisional biopsy of additional skin lesion Shaving of 0.5 centimeters or less skin growth of scalp, neck, hands, feet, or genitals Shaving of 0.6 centimeters to 1.0 centimeters skin growth of scalp, neck, hands, feet, or genitals Shaving of 1.1 to 2.0 centimeters skin growth of scalp, neck, hands, feet, or genitals Shaving of over 2.0 centimeters skin growth of scalp, neck, hands, feet, or genitals Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals Removal of growth (3.1 to 4.0 centimeters) of the scalp, neck, hands, feet, or genitals Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals Trimming of fingernails or toenails Removal of tissue from 1 to 5 finger or toe nails Removal of tissue from 6 or more finger or toe nails Separation of nail plate from nail bed Separation of nail plate from nail bed Removal of blood accumulation between nail and nail bed Removal of nail Biopsy of finger or toe nail Repair of finger or toe nail bed Removal of skin of finger or toe nail Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs Repair of separation of wound closure Repair of wound (2.5 centimeters or less) of neck, hands, feet, and/or genitals Second repair of surgical wound Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet Repair of tissue loss of finger or toe Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 15004 15040 15050 15100 15110 15115 15120 15130 15135 15150 15155 15220 15240 15271 15272 15273 15274 15275

15276 15277

15278 15778 17000 17003 17004

Description

Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)

Relocation of skin (100 sq cm or less) for tissue cultured graft

Skin graft (2 centimeters) to tip of finger or toe

Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children)

Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)

Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)

Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)

Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)

Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)

Skin graft at trunk, arms, or legs (first 25 sq centimeters or less)

Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq centimeters or less)

Relocation of patient skin (20 sq centimeters or less) to scalp, arms, and/or legs

Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less)

Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less)

Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs

Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs (first 100 sq cm or 1% body area of infants and children)

Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs

Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less)

Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes

Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)

Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes

Implantation of artificial material for delayed closure of defects due to soft tissue infection or trauma

Destruction of skin growth

Destruction of 2-14 skin growths

Destruction of 15 or more skin growths

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 17110 17111 17250 20103 20220 20225 20240 20550 20551 20552 20600 20605 20610 20612 20670 20680 20690 20692 20694 20696 20697 20900 27600 27601 27602 27603 27604 27605 27606 27607 27610 27612 27620 27625 27626 27630 27635 27637

Description Destruction of up to 14 skin growths Destruction of 15 or more skin growths Application of chemical agent to excessive wound tissue Exploration of penetrating wound of arm or leg Biopsy of bone using needle or trocar Deep biopsy of bone using needle or trocar Biopsy of bone, open procedure Injections of tendon sheath, ligament, or muscle membrane Injections of tendon attachment to bone Injections of trigger points in 1 or 2 muscles Aspiration and/or injection of small joint or joint capsule Aspiration and/or injection of medium joint or joint capsule Aspiration and/or injection of large joint or joint capsule Aspiration and/or injection of cysts Removal of bone implant Removal of deep bone implant Application of uniplane external bone fixation on one arm or leg Application of multiplane external bone fixation system on one arm or leg Removal of external bone fixation under anesthesia Application of multiplane external bone fixation system on one arm or leg Application of multiplane external bone fixation system Small bone graft harvest Incision of tissue of front and/or lateral muscle compartments of lower leg Incision of tissue of rear muscle compartments of lower leg Incision of tissue of front and/or lateral and rear muscle compartments of lower leg Drainage of abscess or blood collection at lower leg or ankle Drainage of infected fluid-filled sac (bursa) of leg or ankle Incision of Achilles tendon, accessed through the skin using local anesthetic Incision of Achilles tendon, accessed through the skin requiring general anesthesia Incision of bone of leg or ankle Exploration, drainage, or removal of foreign body of ankle Release of ankle joint capsule Exploration of ankle joint Removal of membrane covering of ankle joint Removal of membrane covering ankle joint and tendon Removal of growth of leg and/or ankle tendon lining or capsule Removal or scraping of cyst or growth of either bone of lower leg Removal or scraping of cyst or growth of either bone of lower leg with patient-derived bone graft

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 27638 27640 27641 27650 27652 27654 27658 27659 27664 27665 27675 27676 27680 27681 27685 27686 27687 27690 27691 27692 27695 27696 27698 27700 27702 27703 27704 27705 27707 27709 27760 27762 27766 27767 27768 27769 27786 27788

Description Removal or scraping of cyst or growth of either bone of lower leg with donor bone graft Partial removal of shin bone Partial removal of leg bone Repair of ruptured Achilles tendon, open or through skin procedure Repair of ruptured Achilles tendon with graft, open or through skin procedure Repair of ruptured Achilles tendon Repair of leg tendon Repair of leg tendon Repair of leg tendon Repair of leg tendon Repair of dislocating lower leg tendons Repair of dislocating lower leg tendons Release of leg and/or ankle tendon Release of multiple tendons of leg and/or ankle Lengthening or shortening of tendon of leg or ankle Lengthening or shortening of multiple tendons of leg or ankle Lengthening of calf muscle Transplant of tendon and muscle rerouting at lower leg or ankle Transplant of deep tendon with muscle rerouting at lower leg or ankle Transplant of tendon and muscle rerouting at lower leg or ankle Repair of disrupted collateral ligament of ankle Repair of disruption of both collateral ligaments of ankle Repair of disrupted collateral ligament of ankle Repair of ankle joint Repair of ankle joint with prosthesis Repair of ankle joint with revision of prosthesis Removal of ankle implant Incision of shin bone Incision of leg bone Incision of shin and outer lower leg bones Closed treatment of broken ankle Closed treatment of broken ankle with manipulation Open treatment of broken ankle Closed treatment of broken ankle Closed treatment of broken ankle with manipulation Open treatment of broken ankle Closed treatment of broken ankle Closed treatment of broken ankle with manipulation

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 27792 27808 27810 27814 27816 27818 27822 27823 27824 27825

27826

27827

27828

27829 27830 27831 27840 27842 27846 27848 27860 27870 28001 28002 28003 28005 28008 28010 28011 28020 28022 28024 28035 28039 28041 28043

Description Open treatment of broken ankle Closed treatment of broken ankle Closed treatment of broken ankle with manipulation Open treatment of broken ankle Closed treatment of broken ankle Closed treatment of broken ankle with manipulation Open treatment of broken ankle Open treatment of broken ankle Closed treatment of fracture of lower weight bearing joint of shin bone Closed treatment of fracture of lower weight bearing joint of shin bone with traction and/or manipulation Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula Open treatment of ligament tear at ankle joint Closed treatment of knee joint dislocation Closed treatment of knee joint dislocation under anesthesia Closed treatment of ankle dislocation Closed treatment of ankle dislocation under anesthesia Open treatment of ankle dislocation Open treatment of ankle dislocation with repair or internal or external hardware Manipulation of ankle under general anesthesia Fusion of ankle joint, open procedure Drainage of fluid-filled sac (bursa) of foot Drainage of fluid-filled sac (bursa) of foot Drainage of multiple fluid-filled sacs (bursa) of foot Incision of foot bone Incision of tissues of muscle compartment of foot and/or toe Repair of toe tendon, accessed through the skin Repair of multiple toe tendons, accessed through the skin Incision of foot bone at ankle joint with exploration, drainage, or removal of foreign body Exploration, drainage, or removal of foreign body of foot Exploration, drainage, or removal of foreign body of toe joint Release of nerve between tissue and bone of foot Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe Removal (1.5 centimeters or greater) muscle growth of foot or toe Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 28045 28046 28047 28060 28062 28070 28072 28080 28086 28088 28090 28092 28100 28102 28103 28104 28106 28107 28108 28110 28111 28112 28113 28114 28116 28118 28119 28120 28122 28124 28126 28130 28140 28150 28153 28160 28171 28173

Description Removal (less than 1.5 centimeters) muscle growth of foot or toe Removal (less than 3 centimeters) tissue growth of foot or toe Removal (3 centimeters or greater) tissue growth of foot or toe Partial removal of tissue at sole of foot Removal of tissue at sole of foot Removal of joint lining of foot bone at ankle joint Removal of joint lining at first joint of toe Removal of fibrous nerve growth from between toes Removal of foot tendon Removal of foot tendon Removal of growth of tendon covering or joint capsule of foot Removal of growth of tendon covering or joint capsule of toes Removal or scraping of bone cyst or growth of heel bone Removal or scraping of bone cyst or growth of heel bone with graft from hip or other bone Removal or scraping of bone cyst or growth of heel bone with donor bone graft Removal or scraping of bone cyst or growth of ankle bone Removal or scraping of bone cyst or growth of ankle bone with graft from hip or other bone Removal or scraping of bone cyst or growth of foot bone with donor bone graft Removal or scraping of bone cyst or growth of toes Removal of bunion at fifth toe joint Removal of bone at fifth toe joint Removal of bones at second, third, or fourth toe joints Removal of foot bone at fifth toe joint Removal of multiple foot bones Removal of abnormal bones at ankle joint Removal of heel bone Removal of heel bone spur Partial removal of foot or heel bone Partial removal of foot or heel bone Partial removal of toe bone Removal of bone at base of toe Removal of ankle joint bone Removal of foot bone Removal of toe Partial removal of toe bone joints Partial removal of toe joint Extensive removal of bone growth, middle portion of foot Removal of bone growth of foot

Published: May 2, 2023

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Indiana Health Coverage Programs

Podiatry Services Codes

Table 1 ? Covered Procedure Codes for Podiatrists (Specialty 140) Reviewed/Updated: May 3, 2023

Procedure Code 28175 28190 28192 28193 28200 28202 28208 28210 28220 28222 28225 28226 28230 28232 28234 28238 28240 28250 28260 28261 28262 28264 28270 28272 28280 28285 28286 28288 28289 28291 28292 28295 28296 28297 28298 28299 28300 28302

Description Removal of bone growth of toe Removal of foreign body of foot tissue, accessed beneath the skin Removal of foreign body of foot tissue Removal of foreign body of foot tissue Repair of foot tendon Repair of foot tendon Repair of foot tendon Repair of foot tendon Release of foot tendon Release of multiple foot tendons Release of foot tendon Release of multiple tendons in foot Incision to lengthen foot tendons, open procedure Incision to lengthen toe tendon, open procedure Incision to release foot tendon, open procedure Advancement of ankle tendon with removal of ankle joint bone Incision to release foot muscle tendon Incision to release tissue and muscle of sole of foot Incision of ankle joint capsule to correct foot deformity Correction of foot deformity with incision of ankle joint capsule and tendon lengthening Correction of foot deformity with incision of ankle joint capsule and lengthening of tendons Release of capsule of ankle joint Incision of joint capsule of foot and toe Incision of toe joint capsule Creation of web space between toes Correction of toe joint deformity Correction of fifth toe joint deformity Removal of foot bone spur Correction of rigid deformity of first joint of big toe Correction of rigid deformity of first joint of big toe using implant Correction of bunion Correction of bunion Correction of bunion Correction of bunion Correction of bunion Correction of bunion Incision to repair heel bone Incision to repair ankle joint bone

Published: May 2, 2023

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