Hammertoe - Podiatry Treatments and Coding

Hammertoe - Podiatry Treatments and Coding Podiatry treatments for hammertoe can be non-invasive or surgical, depending on the severity of the deformity and associated symptoms.

More common in women than men, hammertoe causes the toe to bend upward at its middle joint.

The California Podiatric Medical Association defines hammertoe as a contracture—or bending— of the toe at the first joint of the digit, called the proximal interphalangeal joint. The condition can also occur in one or both joints of the second, third, fourth or fifth (little) toes. For podiatrists treating such conditions, medical billing outsourcing is a great option to meet their medical claim submission and reporting tasks.

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Often, patients with conditions such as diabetes, rheumatoid arthritis and neuromuscular conditions are more likely to develop hammertoe. Mainly caused by abnormal balance of the muscles in the toes or by heredity, hammertoe can also be the result of -wearing shoes that aren’t the right size, a toe injury, complication from underlying medical conditions, tightened ligaments or tendons in the foot or pressure from a bunion. Common symptoms of this condition include deformity / prominence of toe, pain, redness or swelling around the joints, corn / callous, bent toes, stiffness in the joints of the toe and difficulty in walking.

Types, diagnosis and treatment There are two types of hammertoe - rigid and flexible. While flexible hammertoe is still movable at the joint and is a milder form of the condition, the rigid type will press the joint out of alignment and the toe can't move. Left untreated, the condition can worsen and become rigid, leading to severe pain.

Diagnosis for hammertoe will be done by performing a physical examination of the foot to study the contracture of the toes and by using imaging techniques like X-rays to identify the degree of the deformity.

Based on the diagnosis, non-surgical treatment options will be considered first, which include padding to prevent your toes from rubbing against the shoe and causing sores, taping to change the imbalance around the toes and thus relieve the stress and pain, splints to keep the toes in the correct place, medications to reduce swelling and pain and orthotic devices like shoe inserts to reduce symptoms and prevent the worsening of the hammertoe deformity. If these non-invasive treatments do not provide results, surgery will be recommended to remove the bony prominence and restore normal alignment of the toe joint and thus relieve pain.

Along with hammer toe, some people may also have other foot problems, such as bunions, heel spurs, or corns. Podiatrists may also recommend certain lifestyle changes such as wearing proper shoes, regular exercise and avoiding heels more than two inches tall.

If hammertoe is not treated, it can get worse and the toes may become rigid, causing pain and making it hard to walk or wear shoes.

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When it comes to reimbursement of hammertoe treatment, Medicare.gov has reported that Medicare Part B (Medical Insurance) covers podiatrist foot exams or treatment if you have diabetes-related nerve damage or need medically necessary treatment for foot injuries or diseases, like hammer toe, bunion deformities, and heel spurs.

Coding While reporting and coding the condition, know whether the patient's hammertoe is acquired or congenital, as the ICD-10 code will change depending on that.

ICD-10 codes for acquired hammertoe include 

M20.4 Other hammer toe(s) (acquired)



M20.40 Other hammer toe(s) (acquired), unspecified foot



M20.41 Other hammer toe(s) (acquired), right foot



M20.42 Other hammer toe(s) (acquired), left foot

If the patient has undergone hammertoe surgery, the possible CPT® code option is 28285. 

28285 Under Repair, Revision, and/or Reconstruction Procedures on the Foot and Toes

Busy physicians and practices can take advantage of podiatry medical billing and coding services provided by experienced medical billing companies.

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