APMA News - September 2013 - (Page 35)

ICD-10: How to Code for Painful Hammer Toes By Lawrence A. Santi, DPM, Member, APMA Coding Committee The APMA Coding Committee has committed to preparing APMA members for the coming of ICD-10 with a blitz of seminars, workshops, webinars, and articles. This article demonstrates how ICD-10 coding will affect your documentation of a typical patient presentation in your ofﬁce. Mr. Jones is a 50-year-old male who presents for an initial visit with painful second, third, and fourth hammer toes on the left foot. He states that the hammer toes have been hurting him for about a year. According to the patient, he has discomfort in his left foot when he ambulates with shoes. He notes that taking his shoes off helps to make his foot feel better. The patient cannot recall any speciﬁc event that caused the deformities or pain. He states that the deformities and symptoms occurred gradually. The problem is not work related. His medical history reveals that he has hypertension that is well-controlled. The physical examination of the lower extremities reveals bilateral pes planus. He has a normal range of motion of the subtalar, midtarsal, and ankle joints. The left forefoot reveals severe rigid contractures of the proximal interphalangeal joints of the second, third, and fourth toes, while the right forefoot reveals slight ﬂexion contractions of the second, third, and fourth toes with a satisfactory, painless range of motion of the proximal interphalangeal joints. Review of the patient’s X-rays reveals contracted second, third, and fourth toes on the left foot with no joint space noted at the proximal interphalangeal joints. All of the other joints appear normal. On the lateral view, the foot appears ﬂattened with a signiﬁcant decrease of the calcaneal inclina- tion angle. The remainder of the X-ray studies were unremarkable for pathology. In the above clinical example, our working diagnoses would include: 1. Painful hammer toe deformities, left foot (coded as ICD-9 735.4) 2. Pes planus, bilateral (coded as ICD-9 734.0) 3. Pain in joints of toes, left foot (coded as ICD-9 719.47) To determine the diagnosis coding under ICD-10, you would follow a process similar ICD-9 code searches. Start in the ICD-10-CM Alphabetic Index. Look under “H” for hammer toe: Hammer toe Deformity, toe, hammer toe You are instructed to look under “Deformity,” so move on to “D”: Deformity toe (acquired) M20.6hammer toe M20.4Note: While “Deformity, toe (acquired)” includes a list of multiple types of deformities, there is only one speciﬁc to the presenting deformity: hammer toe (M20.4-). The hyphen at the end of ICD-10 M20.4- indicates additional character(s) are required. Those will be found in the ICD-10 Tabular List . . . To read the rest of this article, and to explore more ICD-10 resources available to you, visit www.apma.org/ICD10. Look for more ICD-10 tutorials in the October issue! ■ Was Your Medical Claim Improperly Denied? Want to contact the insurance company? Or how about appeal a claim that was denied for non-coverage despite a pre-service veriﬁcation of beneﬁt? Want to a send a letter asking about the fee schedule? Chapter 12 of the APMA Private Insurance Resource Guide (PIRG) provides sample letters and forms used by members and reviewed by counsel. The PIRG is available for APMA members only and can be accessed at www.apma.org/PIRG. Questions? Contact the APMA Health Systems Committee at healthsystems.hpp@apma.org. APMA News September 2013 35 http://www.apma.org/ICD10 http://www.apma.org/PIRG

Table of Contents for the Digital Edition of APMA News - September 2013

APMA News - September 2013
President’s Message
Contents
What Happens in Vegas: The 2013 Annual Scientific Meeting
Annual Scientific Meeting Sponsors
Humanitarian Surgical Missions: A Different Kind of Residency Training
Collaboration is Key at Limb Salvage Clinic
Center for Professional Advocacy Reviews Recent California Medicaid Lawsuit
Oregon Podiatrists Achieve Physician Status
Letters to the Editor: Solving Our Residency Crisis; Remembering Our Heroes
Resolutions Submission Deadlines
Reimbursement
ICD-10: How to Code for Painful Hammer Toes
Federal Advocacy Forum
Cosponsors to the Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians Act
APMAPAC Chair Report
Coverage Corner
Bylaws Propositions Due
IT Consultant
Website Wisdom
On the Road with APMA
Small Business 101
CPME Update
In Short
Worthy of Note
Affiliates Corner
New Members
Death Notices
APMAPAC Update
Development Update
Classified Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA

APMA News - September 2013