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When the excision of a heel spur is complicated by associated conditions, comprehensive documentation of those conditions and the added procedures and supplies needed to treat them will lead to appropriate reimbursement For spur, with or without plantar fascial release,” which would be reported when there is a spur on the bottom of the foot and a plantar fascial release may The coding for the removal of a heel (calcaneus) spur [see box on page 5] is uncomplicated

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Code 28119 (ostectomy, calcaneus for spur, with or without plantar fascial release. Cpt code 28118 represents, “ostectomy, calcaneus.” now cpt code 28119 represents, “ostectomy, calcaneus Report the excision with 15946 excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure

You may claim the subsequent muscle flap closure separately with 15734 muscle, myocutaneous, or fasciocutaneous flap

Append modifier 58 to show this was a staged (planned) procedure. A quick glance of the cpt code descriptors will reveal which codes include ostectomy For instance, 15931 describes excision of a sacral pressure ulcer with primary suture, while 15933 describes the same procedure but also with ostectomy to account for further bone removal below the ulcer site. Consequently, you will choose an appropriate excision code according to the ulcer's location, whether the procedure includes ostectomy and the type of closure, as illustrated in the charts on page 87

For pressure ulcer excision in an unlisted location, you must choose 15999 (unlisted procedure, excision pressure ulcer). Keep these tips in mind when reporting heel spur claims in your practice Check out heel spur surgery options if your provider performs surgery for a heel spur, you have three different cpt® codes to choose from If your provider excises a heel spur and removes a part of the calcaneus, you should report 28118 (ostectomy, calcaneus).

If a haglund's deformity of the heel and retrocalcaneal bursa were removed, then code 28118, ostectomy, calcaneus, should be reported

Retrocalcaneal spur 28118 ostectomy, calcaneus This code is for a bone spur removal on the back of the heel, through the achilles tendon Achilles repair is a component of 28118 (retrocalcaneous) and 28119 (plantar heel spur) It is not appropriate to report achilles repair unless documentation supports tendon tear or degeneration and as a result additonal work needs to be done to the tendon.

The ostectomy may be done to prepare the base for a muscle or skin flap In this case, you report code 15937 (excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure With ostectomy) for sacral ulcer and code 15958 (excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous.