APMA's Coding Briefs offer valuable insights and guidelines that navigate podiatrists through appropriate coding. This information is aimed at increasing coding accuracy, ensuring compliance with regulations, and improving documentation, all of which may help to reduce the burden of denials.
APMA has Coding Briefs on the following topics:
To learn more about E/M coding, visit APMA's E/M Resource Page.
When and Why: Importance of CPT ® 99024
Use CPT® 99024 for most postoperative encounters occurring during the 10- or 90-day global period that accompanies a procedure or surgery. Many providers do not submit this CPT code because there is no direct reimbursement associated with it. However, it is important to document these encounters and submit CPT 99024 as it is an important source of information the AMA RVS Update Committee and CMS use for reference to build in the value of post-op care to surgical and procedural codes. If they see no post op encounters submitted, they can argue for a decreased RVU assuming the provider is not seeing the patient and providing care during the global period.
Hardware Removal
When choosing hardware removal codes, providers often must select between CPT® 20670 (Removal of implant; superficial (e.g., buried wire, pin, or rod) (separate procedure))* and CPT® 20680 (Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod, or plate))* for services that do not fall under a global period. For removal of hardware such as a K-wire from a previous bunionectomy, under local anesthesia in an office setting, CPT® 20670 is appropriate. If more complex hardware removal is performed in an outpatient setting, such as removing a buried screw from a previous medial malleolar fracture repair, then CPT® 20680 is appropriate.
*CPT® 20670 includes the words "separate procedure" and thus cannot be submitted as part of another procedure performed at the same anatomical site. Providers should also know the number of units of these codes submitted should relate to the number of anatomical sites addressed. For instance, removal of a buried plate with four screws through one incision would be submitted as one unit of service.
Billing an Imaging Service and an E/M on the Same Day
Multiple third party payers are more strictly enforcing documentation requirements associated with submission of radiology services. When both a radiology CPT® code and E/M service are submitted for the same patient on the same day, both an order for the imaging and a full written interpretation must be documented. The order documentation should include the patient’s name, the study being ordered, anatomy being addressed, number and type of views, the clinical indication(s) for the imaging, and the ordering provider’s name and signature. The interpretation documentation should include all findings, both pertinent to the chief complaint and not pertinent to the chief complaint, and what decisions were made as a result of the imaging.
Learn more about this topic at the upcoming webinar, Radiology Services: Coding and Documentation, taking place April 14, 2026, at 8:00 p.m. ET.
Reference: Page 4, December 2002 CPT Assistant Newsletter
Routine Foot Care (At-Risk Foot Care)
The CMS 59 Modifier Article states: “Modifier 59 may be reported with code 11720 if one to five nails are debrided and a hyperkeratotic lesion is pared on a toe other than one with a debrided toenail?or?the hyperkeratotic lesion is proximal to the skin overlying the distal interphalangeal joint of a toe on which a nail is debrided.”
Line 1: 11055 - Q8
Line 2: 11720-59, Q8
However, if the callus was at the distal tip of the right 2nd toe (not proximal to the?distal interphalangeal joint)?and the right 2nd mycotic toenail was derided, both services could not be submitted.
Learn more and find resources related to billing routine foot care with the -59 modifier via APMA's -59 Modifier Toolkit.
Coding Brief - Z Codes in ICD-10-CM, Do Not Overlook Them!
Z codes within the ICD-10-CM code set capture a wide range of factors that are important to the patient’s health but may not necessarily indicate a specific disease state. Some examples include: Z89.421 (Acquired absence of other right toe(s)), Z99.3 (Dependence on wheelchair), Z59.02 (Unsheltered homelessness), and Z70.01 (Long term (current) use of anticoagulants). While these codes are rarely submitted alone and should not be the primary diagnosis code, utilizing Z codes is important in some value-based payment models, captures data for analytics and utilization, and for some hospital and health-system employed podiatrists, documenting AND coding social determinants of health via Z codes may be a “pay for performance” item in the physician contract.
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