Podiatric billing requires careful attention to foot and ankle anatomy, diabetic foot care rules, and nail debridement frequency policies. This page covers the most frequently billed ICD-10-CM diagnosis codes and CPT procedure codes used by podiatrists across the United States.
FY 2026 ICD-10-CM (CMS) · CPT codes updated annually · All codes verified billable · Last verified: June 2026
Osteotomy with or without lengthening/shortening; metatarsal
N/A
-LT, -RT
28820
Amputation, foot; at metatarsophalangeal joint, great toe
N/A
-LT, -RT, -TA
97597
Debridement, selective; first 20 sq cm or less
~$71
-59, -RT, -LT
97598
Debridement, selective; each additional 20 sq cm (add-on code)
~$38
-59
99213
Office visit, established patient, low complexity, 20-29 min
~$93
-25, -52, -GT
99214
Office visit, established patient, moderate complexity, 30-39 min
~$133
-25, -52, -GT
29540
Strapping; ankle and/or foot
~$24
-LT, -RT
64455
Injection, anesthetic/steroid; plantar common digital nerve (Morton’s neuroma)
~$87
-LT, -RT, -50
20610
Arthrocentesis/injection, major joint or bursa; without ultrasound guidance
~$77
-LT, -RT, -59
Nail Avulsion and Repair
11730
Avulsion of nail plate, partial or complete; single nail
~$64
-LT, -RT, -TA to -T9
11732
Avulsion of nail plate; each additional nail (add-on to 11730)
~$43
add-on, -LT/-RT
11740
Evacuation of subungual hematoma
~$59
-LT, -RT
11755
Biopsy of nail unit
~$87
-LT, -RT, -59
11765
Wedge excision of skin of nail fold
~$79
-LT, -RT
*Approximate 2025 CMS national non-facility rate. Rates vary by geography, setting, and payer contract. Refer to the CMS Physician Fee Schedule for official rates.
Top Denial Reasons for Podiatry Claims
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Routine Foot Care Denied for Non-Diabetic Patient
Medicare requires a qualifying systemic condition (eg, E11.621) to justify nail debridement under codes 11720-11721. Ensure the qualifying diagnosis is documented and linked to the nail care procedure on the claim.
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Missing -25 Modifier on Same-Day E/M and Procedure
When an office visit (99213/99214) is billed the same day as a procedure such as corn paring or strapping, append the -25 modifier to the E/M code. Without it, payers bundle the visit into the procedure payment and deny the E/M charge.
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Insufficient Documentation for Wound Debridement
Selective debridement (97597/97598) requires documentation of wound size in square centimeters, tissue depth, and wound type in every clinical note. Claims denied for medical necessity can be appealed with a detailed wound assessment attached to the request.
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Bilateral Procedure Billed Without -50 Modifier or Separate Line Items
Procedures performed bilaterally (eg, Morton’s neuroma injections on both feet) must include the -50 modifier or be submitted on two lines with -RT and -LT. Omitting laterality modifiers results in denial or payment for only one side.
Podiatry Billing & Coding Tips
Routine nail debridement (11721) requires a ‘class findings’ diagnosis for Medicare coverage — document systemic conditions like diabetes, PVD, or poor circulation that impair self-care.
Diabetic foot ulcer codes (E11.621) require the diabetes code first (E11.x) followed by the ulcer site code (L97.x) as an additional code.
Bunion correction CPT codes (28296 vs 28299) differ by technique — the operative note must specify the procedure performed.
Orthotics (L codes, HCPCS) require a detailed written order from the treating physician and proof of medical necessity before billing.
M77.30 is calcaneal spur, unspecified foot — this is the most commonly used code for plantar fasciitis billing. M72.2 (Plantar fascial fibromatosis) is a separate, distinct condition. Some coders use M79.671 (foot pain) as an additional code to support the clinical picture.
What is the class findings requirement for routine nail debridement?
Medicare requires documented Class A findings (absent pedal pulse, claudication, trophic changes) or Class B findings (diabetes, PVD, peripheral neuropathy) to support medical necessity for 11720/11721. Without a qualifying systemic condition, routine nail care is not covered by Medicare.
Is E11.621 coded as primary or secondary?
E11.621 (Type 2 DM with foot ulcer) should be coded as the primary diagnosis when the diabetic foot ulcer is the reason for the encounter. Add the site-specific ulcer code (L97.x) as an additional code to specify location and depth.
What CPT is used for bunion surgery?
28296 is the most common code for hallux valgus correction with distal metatarsal osteotomy (Chevron procedure). 28299 is for complex bunion corrections. The operative note must document the exact osteotomy technique to support the code selected.
How does OmniMD support podiatry practices?
OmniMD’s Podiatry EHR includes foot diagram documentation tools, diabetic foot exam templates meeting ADA guidelines, and class findings documentation prompts to ensure Medicare coverage for nail debridement services.
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