Reporting Morton’s Neuroma with the Right Medical Codes

Reporting Morton’s Neuroma with the Right Medical Codes Podiatry treatment options for Morton’s Neuroma condition will be reimbursed only if the practice proves it to be medically necessary.

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A painful foot condition, Morton’s Neuroma occurs when a nerve near the toes becomes compressed and inflamed. It refers to a growth on nerve tissue that occurs in the nerve of the foot. A Morton’s Neuroma can develop from tight fitting shoes, injuries, and other pressuring irritants. It often occurs between the third and fourth toes. Podiatry billing and coding services provided by experienced hands will help to report this condition correctly in the medical claims and thus bring in accurate payment.

Key symptoms are that the patient feels like standing on a pebble in the shoe, a burning pain in the ball of the foot that may radiate into the toes and tingling or numbness in the toes. The symptoms are usually felt up the sides of the space between the two toes.

Pain occurs when the nerve connecting the toe bones (metatarsal bones) becomes irritated or compressed.

The condition can be caused by wearing high-heeled shoes, taking part in high-impact athletic activities such as jogging or running or having any foot deformities such as bunions, hammertoes, high arches or flatfeet. If diagnosed early, many cases of Morton’s Neuroma can be treated without surgery.

Diagnosis and Treatment Diagnosis will be done based on certain imaging tests such as Xrays, Ultrasound scan or MRI scan. X-rays can also help to rule out other conditions, such as a fracture or arthritis. Multiple treatment approaches have been utilized for Morton’s Neuroma, depending on the severity of your symptoms. Podiatrists will likely recommend trying conservative approaches first such as  Wearing low heel shoes with a wider toe area  Using shoe orthotics can help reduce pressure  Regular ice massaging to reduce pain

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 Pain medications such as ibuprofen to help reduce swelling and pain  Reducing activities such as jogging, aerobic exercise or dancing If conservative treatment options don’t provide relief to symptoms, podiatrists may recommend other treatment options such as –  Injections - Corticosteroid injections to reduce pain and inflammation or alcohol sclerosing injections to harden the nerve area and relieve pain  Release surgery – An incision will be made on the top of the foot to access the ligament that covers the nerve and the pressure will be released from the nerve  Surgical removal of the growth - The neuroma is surgically removed through the bottom of the foot and the incision is closed with stitches

Relevant Medical Codes Medicare as well as many private insurance plans covers the charge for Morton’s Neuroma treatment, only if it is medically necessary. According to Amerigroup Real Solutions, injections of anesthetic, sclerosing or steroid agents for treating Morton’s neuroma will be considered medically necessary only if conservative therapies such as padding or orthotic devices, activity modification, changes in shoe wear or medications such as nonsteroidal anti-inflammatory drugs fail.

CPT  64455 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma)

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 64632 Destruction by neurolytic agent; plantar common digital nerve (reported for a neuroma injection involving the plantar nerves in the foot)  28080 Excision, interdigital (Morton) neuroma, single, each describes the surgical excision of the Morton’s neuroma.

ICD-10 Procedure  3E0T33Z Introduction of anti-inflammatory into peripheral nerves and plexi, percutaneous approach  3E0T3BZ Introduction of anesthetic agent into peripheral nerves and plexi, percutaneous approach  3E0T3TZ Introduction of destructive agent into peripheral nerves and plexi, percutaneous approach ICD-10 Diagnosis    

G57.60 G57.61 G57.62 G57.63

Lesion Lesion Lesion Lesion

of of of of

plantar plantar plantar plantar

nerve, nerve, nerve, nerve,

unspecified lower limb right lower limb left lower limb bilateral lower limbs

These diagnosis codes are to be used in support of CPT codes 64455 or 64632. Podiatry practices can benefit from the medical coding services provided by professional medical billing companies.

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