Coding and Regulatory Updates in Podiatric Medicine 2023May 25, 2023
Podiatric medicine is a specialized field that deals with diagnosing, treating, and preventing foot and ankle conditions. Like any medical facility, the podiatry specialty is subject to ongoing updates and changes in coding and regulatory requirements.
As a podiatrist, you must keep up with these changes to remain compliant with regulations and ensure proper service reimbursement. In this blog, we will provide insight and information to help you stay up-to-date and informed on the latest podiatry coding and regulatory updates in podiatric medicine for 2023.
Updates to the CPT Podiatry Codes for 2023
As part of its annual update, the American Medical Association released the Current Procedural Terminology (CPT®) code set, which took effect on January 1. The laws and regulations relevant to the podiatry specialty are constantly changing, adding, and deleting.
This part discusses some of the podiatry CPT code changes for 2023 that are most relevant for podiatrists.
Evaluation and Management E/M Level Selection
Significant changes will be in how certain evaluation and management (E&M) levels are selected in 2023. Moreover, the November/December 2022’s edition of Podiatry Management included extensive coverage of this topic.
As a result of those changes, beginning January 1, 2023, medical decision-making or total time will be the only criteria used to select E&M services at the office or other outpatient facility, hospital inpatient and observation facility, consultation, emergency department, nursing facility, or residence.
Starting January 1, 2023, the CPT codes for Observation Care E&M have been removed, meaning that codes 99218-99220 and 99224-99226 are no longer valid. The Hospital Inpatient E&M codes (CPT 99221-99223 and 99231-99233) will be updated to “Hospital Inpatient or Observation Care E&M” due to this change. This means that healthcare providers will now use the same E&M codes for patients who are admitted to the hospital under observation or inpatient status.
As of January 1, 2023, the CPT codes for delivering healthcare services in domiciliary settings, rest homes, or custodial care facilities will no longer be available. Thus, the CPT codes 99324-99328 and 99334-99337 will be removed from the code set.
Patients receiving care in any of these settings will instead use a core set of codes:
- Domiciliary care
- Rest homes
- Custodial care
Therefore, the CPT codes mentioned above will be invalid starting on January 1, 2023.
Codes 99324-99328 and 99334-99337 are no longer valid for services provided at home, in a rest home, or in a custodial setting starting January 1, 2023. This change also updates the Home Visit E&M codes (CPT 99341-99345 and 99347-99350) to “Home or Residence Visit E&M.” For your podiatry practice, you will use the same E&M code set for patients in a domiciliary, rest home, custodial care, or home setting.
The CPT code 99241, indicating an office consultation for new or established patients requiring a patient history, examination, and straightforward medical decision-making, will also be removed.
The following two CPT codes now represent the removal of sutures/staples:
|15853||Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code).|
|15854||Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)|
Any provider who removes the sutures or staples can use these CPT codes if the patient is not in a global period.
A medically necessary E&M service must be performed and documented to submit the new suture or staple removal codes. These codes can only be submitted as an add-on to specific E&M services, including:
- CPT codes 99202-99205
- CPT codes 99211-99215,
- CPT codes 99281-99285,
- CPT codes 99341-99345,
- CPT 99347-99350, and others.
Since these are add-on codes, E&M services performed in the same visit do not need to be significantly separate from the suture/staple removal procedure.
The following are common podiatric procedures that may involve sutures/staples with zero-day global periods:
|28820||Amputation, toe; metatarsophalangeal joint CPT 28825—Amputation, toe; interphalangeal joint|
|28001||Incision and drainage, bursa, foot|
|28002||Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space|
|28003||Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas|
Codes for different doses and booster shots of COVID-19 vaccination are now available in the 2023 CPT code set. As a provider, you must refer to the complete and updated code set when administering these vaccines. This process ensures you are using the appropriate code for each vaccine type and dose. However, vaccine administration alone without E&M services is ineligible to submit a CPT code indicating an E&M service.
New Ultrasound Code CPT
The CPT code represents an image of the entire course of a nerve rather than just parts or areas of inflammation.
|76883||Ultrasound of nerve(s) and surrounding structures along their entire anatomic course in one extremity, including real-time cine imaging with image documentation per extremity.|
CPT clarifies the proper use of this CPT code:
An extensive nerve evaluation examines the entire course of a nerve in an extremity. Films and static images illustrating a nerve’s path through an extremity can be acquired and archived to demonstrate anatomy.
According to the American Medical Association (AMA) CPT Editorial Panel, the method used to select the level of these E&M service types will also change on January 1, 2023:
- Home or Residence
- Emergency Department
- Hospital Inpatient and Observation Care
- Nursing Facility
This modification allows the flexibility to select the office or another outpatient, hospital inpatient, observation care, consultations, emergency departments, nursing facilities, and home or residence E&M services according to medical decision-making or total time.
Please take note:
The CPT codes referenced or displayed above are trademark registered and copyrighted by the American Medical Association. All rights are reserved, and this information is being shared solely for educational purposes.
About the 2023 CPT Podiatry Codes
These are only several changes relevant to podiatrists in the 2023 CPT code set. Before you submit CPT codes, you must be knowledgeable about the complete CPT code set. All healthcare providers should use the new 2023 CPT code set on or after January 1, 2023.
Furthermore, the Coders Specialty Guide 2023 for podiatry specialty utilizes a one-page layout for each CPT code, providing all the necessary information in a concise and accessible manner.
For your podiatry practice, you can buy the complete Podiatry CPT Codes 2023 here:
Updates on Accreditation Program Regarding Podiatry: Quick Overview
If you’re a podiatrist interested in learning more about treating diabetic foot syndrome, you shouldn’t miss the Great Debates & Updates (GDU) in Diabetic Foot. It is an annual event in Dallas, TX, from November 30 to December 2, 2023. The program is designed specifically for the podiatry specialty. You can learn from other podiatrists and engage in debates regarding controversial treatment options by attending the event.
By February 2, 2024, participants must complete the online evaluation and the general survey to receive documentation of credit for each session attended. While this might be too advanced, it can benefit you and your practice to be more progressive in treating diabetic foot syndrome.
Go to this website for more information.
Keeping Up With the Latest Changes
A provider must stay updated with regulatory changes to ensure compliance. Keeping up with industry changes requires a subscription to industry publications, attendance at conferences, and participation in webinars. By doing this, you can remain compliant and avoid future penalties.
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