Coding Calcaneal Spurs – A Common Heel Pain Condition

Coding Calcaneal Spurs – A Common Heel Pain Condition A heel spur is a pointed bony outgrowth of the heel bone. The article provides a good overview of the condition along with the diagnosis codes.

Regarded as a common source of heel pain, calcaneal spurs are bony growths attached to your heel bone (calcaneus) that grows into your foot arch. Also called heel spurs or osteophytes, these often form at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur) and eventually affects other parts of the foot. The dorsal spurs are often associated with Achilles, while spurs under the sole are associated with plantar fasciitis. These spurs are normally about a quarter of an inch in length; hence they may not necessarily be visible to the naked eyes. As heel spurs are symptomatic and don’t always cause pain, diagnosing and treating

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the condition can be challenging. Podiatric practices can depend on a professional podiatry billing company to simplify their claims processing tasks.

Heel spurs are caused by long-term muscle and ligament strain. The excessive muscle and ligament strain stretches and wears out the soft tissues in the heel. Repetitive stress from activities like walking, running, or jumping on hard surfaces can also cause heel spurs. Reports suggest that more than half of all cases of heel spurs occur in people who have plantar fasciitis – a condition that causes inflammation across the bottom of the foot, especially the heel. The heel can also become more vulnerable with age. As a person ages, the pads in the heel wear down and fail to provide shock absorption. Over time, calcium deposits can build up under the heel and these deposits form bony protrusions, which are heel spurs. Other possible causes include – arthritis, excess body weight, poorly fitting shoes, bruising of the heel, worn-out shoes and wearing flip-flops too often.

Symptoms of Calcaneal Spurs The condition is associated with heel pain and tenderness of the tissues adjacent to the spur, such as on the bottom of the heel or at the back of the heel where the ligament (plantar fascia) or Achilles tendon attach. This can make it extremely difficult for people to stand, walk, or run, especially when barefoot on hard surfaces (due to tenderness and pain at the back of the heel or under the heel). Common symptoms include – 

Sharp pain (like a knife) in the heel when standing up in the morning

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Small, visible bone-like protrusion under the heel

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Inflammation and swelling at the front of the heel

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Heat radiating from the affected area

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A dull ache in the heel throughout the rest of the day

These symptoms may spread to the arch of your foot and eventually a small bony protrusion may be visible. However, not everyone with a heel spur will experience all of the above symptoms.

Often, this condition is identified only when the person undergoes certain diagnostic imaging tests.

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Diagnosing and Treating Calcaneal Spurs Diagnosis of this condition begins with a physical examination and detailed review of previous medical history. X-ray imaging of the foot will be performed to identify the bony prominence (spur) of the heel bone (calcaneus). If the spur is symptomatic, identifying the underlying condition such as plantar fasciitis, Achilles tendonosis, or a systemic arthritis is required in order to treat appropriately. Ultrasound scans and MRI are used to identify plantar fasciitis tears, inflammation or calcification. In addition, pathology tests (including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.

Treatment modalities for heel spurs include – rest, cold therapy, anti-inflammatory medications, wearing custom-made orthotics (shoe inserts) and cushioned sports shoes, and cortisone injections. Taking adequate amount of rest and taking pressure off the feet can help reduce pain and swelling in the affected area. Cold therapy is used relieve inflamed heel tissue. Over-thecounter (OTC) anti-inflammatory medications like aspirin, ibuprofen (Advil, Motrin) and naproxen sodium/naproxen (Aleve) can reduce heel pain and discomfort. Wearing comfortable and well-fitting shoes can reduce the amount of pressure on the heel spur that causes pain and discomfort. In addition, patients can also opt for custom orthotics (molded shoe inserts) that can be slipped into the shoes. These help prevent the foot from rolling and provide extra heel support. In cases where treating the symptoms is not effective, surgery to detach the plantar fascia ligament from the heel bone will be recommended as a last option.

Podiatry coding and billing can be challenging as it involves using several code categories.

Podiatric surgeons or other specialists who treat heel spurs must use the relevant codes to document the diagnosis, screening and other treatment procedures performed. Billing and coding services offered by reputable companies are the best option to ensure the correct medical codes for medical billing process. ICD-10 codes for calcaneal spurs include 

M77.3 Calcaneal spur

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M77.30 Calcaneal spur, unspecified foot

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M77.31 Calcaneal spur, right foot

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M77.32 Calcaneal spur, left foot

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Preventing calcaneal spurs requires a careful attention to overall foot health. Reduce the amount of stress you place on your feet and try to take adequate rest at the end of each day. Never ever ignore any type of heel pain that develops, even if it is mild pain. Continuing to walk, exercise or wear shoes that cause pain can lead to several other complications.

Knowing the specific medical codes related to calcaneal spurs treatment procedures is important for podiatrists. Partnering with an experienced medical billing outsourcing company can help podiatrists ensure accurate and timely claim submissions.

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