EmailCallus reduction performed by a podiatrist
Publication Date: May 2021
Implementation Date: 1/06/2021
Updated Date: 21/09/2021
ICD 10 AM Edition: Eleventh Edition
Query Number: 3712
ACCD published advice in March 2017 regarding callus reduction performed on the ward by a podiatrist. The advice was that this should be coded to the general allied health code for podiatry 95550-04 [1916]. Would you please advise if this advice still applies?
If so, does the documentation have to specify "reduction of callus"? Would it apply to documentation of "sharps removal of hyperkeratosis and corns"?
We have been discussing whether we should be clarifying these procedures with the podiatrist (ie asking if they are "debridement"). If confirmed as debridement, the default code would be "excisional debridement".
Search Detail:
ACCD March 2017 - callus reduction performed by a podiatrist
Eleventh edition FAQ - wound management
Foot debridement of diabetic patient VICC 2215 - retired
If so, does the documentation have to specify "reduction of callus"? Would it apply to documentation of "sharps removal of hyperkeratosis and corns"?
We have been discussing whether we should be clarifying these procedures with the podiatrist (ie asking if they are "debridement"). If confirmed as debridement, the default code would be "excisional debridement".
Search Detail:
ACCD March 2017 - callus reduction performed by a podiatrist
Eleventh edition FAQ - wound management
Foot debridement of diabetic patient VICC 2215 - retired
Response
VICC advises that IHPA Coding Rule Q3059 Callus reduction performed by Podiatrist is current and therefore still applies.
VICC notes that the IHPA advice states ‘Callus reduction by a podiatrist involves progressively reducing the thickness of the callus using either lateral cutting strokes from a scalpel blade, or the abrasive action of a diamond electro-deposition file, until callus removal is complete’. VICC sought clinical advice which confirmed documentation of ‘sharps removal of hyperkeratosis and corns’ to be synonymous with ‘cutting strokes from a scalpel blade’. VICC therefore advises to assign 95550-04 [1916] Allied health intervention, podiatry for documentation of ‘sharps removal of hyperkeratosis and corns’ by the podiatrist.
VICC does not consider documentation of ‘sharps removal of hyperkeratosis and corns’ by the podiatrist a basis to query debridement.
Note: Following a review by the committee, the response has been updated for clarity:
VICC advises that IHPA Coding Rule Q3059 Callus reduction performed by Podiatrist is current and therefore still applies. VICC notes that the Coding Rule does not cover reduction of hyperkeratosis, but considers that similar advice would apply.
VICC notes that the Coding Rule states: ‘Callus reduction by a podiatrist involves progressively reducing the thickness of the callus using either lateral cutting strokes from a scalpel blade, or the abrasive action of a diamond electro-deposition file, until callus removal is complete’. VICC sought clinical advice that confirmed that ‘sharps removal of hyperkeratosis and corns’ could be synonymous with ‘cutting strokes from a scalpel blade’ as a form of callus reduction. The clinical advice also confirmed that callus or hyperkeratosis reduction without a wound would not be considered debridement.
Therefore, for documentation of ‘sharps removal of hyperkeratosis and corns’ by a podiatrist without documentation of a wound (a condition causing a break in the skin or other body tissues, for example, an ulcer), apply the advice in Coding Rule Q3059 and assign 95550-04 [1916] Allied health intervention, podiatry. Where a wound is documented in addition to the hyperkeratosis or corns/callus, a documentation query could be submitted to clarify if debridement has been performed. If debridement is not confirmed, only assign 95550-04 [1916] Allied health intervention, podiatry.
VICC notes that the IHPA advice states ‘Callus reduction by a podiatrist involves progressively reducing the thickness of the callus using either lateral cutting strokes from a scalpel blade, or the abrasive action of a diamond electro-deposition file, until callus removal is complete’. VICC sought clinical advice which confirmed documentation of ‘sharps removal of hyperkeratosis and corns’ to be synonymous with ‘cutting strokes from a scalpel blade’. VICC therefore advises to assign 95550-04 [1916] Allied health intervention, podiatry for documentation of ‘sharps removal of hyperkeratosis and corns’ by the podiatrist.
VICC does not consider documentation of ‘sharps removal of hyperkeratosis and corns’ by the podiatrist a basis to query debridement.
Note: Following a review by the committee, the response has been updated for clarity:
VICC advises that IHPA Coding Rule Q3059 Callus reduction performed by Podiatrist is current and therefore still applies. VICC notes that the Coding Rule does not cover reduction of hyperkeratosis, but considers that similar advice would apply.
VICC notes that the Coding Rule states: ‘Callus reduction by a podiatrist involves progressively reducing the thickness of the callus using either lateral cutting strokes from a scalpel blade, or the abrasive action of a diamond electro-deposition file, until callus removal is complete’. VICC sought clinical advice that confirmed that ‘sharps removal of hyperkeratosis and corns’ could be synonymous with ‘cutting strokes from a scalpel blade’ as a form of callus reduction. The clinical advice also confirmed that callus or hyperkeratosis reduction without a wound would not be considered debridement.
Therefore, for documentation of ‘sharps removal of hyperkeratosis and corns’ by a podiatrist without documentation of a wound (a condition causing a break in the skin or other body tissues, for example, an ulcer), apply the advice in Coding Rule Q3059 and assign 95550-04 [1916] Allied health intervention, podiatry. Where a wound is documented in addition to the hyperkeratosis or corns/callus, a documentation query could be submitted to clarify if debridement has been performed. If debridement is not confirmed, only assign 95550-04 [1916] Allied health intervention, podiatry.
