ICD-10 Coding for Plantar Fasciitis(M72.2)
Complete ICD-10-CM coding and documentation guide for Plantar Fasciitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Plantar Fasciitis
M72-M77Primary Range
Disorders of synovium and tendon
This range includes conditions related to fibroblastic disorders, including plantar fasciitis.
Key Information: ICD-10 code for plantar fasciitis
Essential facts and insights about Plantar Fasciitis
Primary ICD-10-CM Code for plantar fasciitis
Decision Criteria
clinical Criteria
- Presence of morning heel pain and tenderness at medial calcaneal tubercle.
documentation Criteria
- Documented thickening of plantar fascia on imaging.
Applicable To
- Plantar fasciitis
Excludes
- Calcaneal spur (M77.3-)
Clinical Validation Requirements
- Tenderness to palpation at medial calcaneal tubercle
- Pain worst with first morning steps, improves with activity
- Thickened plantar fascia >4mm on ultrasound
Code-Specific Risks
- Misuse with calcaneal spur codes without proper documentation
- Incorrect use if only heel pain is documented
Coding Notes
- Ensure documentation specifies plantar fasciitis and not just heel pain.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Calcaneal spur
M77.3-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Plantar Fasciitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M72.2.
Impact
Clinical: May lead to incorrect diagnosis and treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Ensure detailed documentation of exam findings., Use specific terminology like 'plantar fasciitis'.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure M72.2 is used as primary when plantar fasciitis is diagnosed.
Impact
Using incorrect codes for plantar fasciitis can lead to audits.
Mitigation Strategy
Ensure thorough documentation and correct code selection.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Plantar Fasciitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Plantar Fasciitis
Use these documentation templates to ensure complete and accurate documentation for Plantar Fasciitis. These templates include all required elements for proper coding and billing.
Chronic plantar fasciitis with failed conservative treatment
Specialty: PodiatryRequired Elements
- Patient history of heel pain
- Physical exam findings
- Imaging results
- Treatment history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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