The podiatry services maximum allowable fee schedule lists the most current allowable procedure codes for podiatry service providers. Not all services identified by CPT or HCPCS codes are covered. Other CPT and HCPCS codes have limitations (e.g., require PA). Providers are required to use the most current podiatry fee schedule in conjunction with the most current CPT and HCPCS references to determine coverage of services.
The following table lists the current allowable procedure codes and descriptions for covered podiatry services.
Service | Current Procedural Terminology Codes | Allowable Modifier(s) |
|---|---|---|
Surgery |
10060-10061, 10120-10180, 11000-11001, 11040-11043, 11055-11057*, 11100-11101, 11200-11201, 11300-11311, 11400-11426, 11620-11626, 11719*, 11720-11765, 11900-11901, 12001-12005, 12020, 12041-12044, 13160, 15000, 15050-15261, 15275-15276, 15350, 15365, 15400, 15786-15787, 16000-16010, 17000-17250, 20000-20005, 20103, 20200-20205, 20520-20525, 20550, 20600-20606*, 20612, 20670-20680 |
|
20816 |
80 |
|
20924, 27603-27630 |
||
27637 |
80 |
|
27638, 27647-27703, 27707, 27808-27829, 27830-27871 |
||
27880 |
80 |
|
27881-27899, 28001-28288, 28289-28299*, 28300-28360, 28400*, 28405-28531, 28540-28636, 28645-28666, 28675-28760, 28800-28805, 28810-28825, 28899, 29305-29445, 29450*, 29505-29515, 29540-29581, 29700-29740, 29750*, 29799 |
||
29891-29892 |
80 |
|
29895-29898 |
80 |
|
29899-29905 |
||
29906 |
80 |
|
29907-29999 |
||
29893* |
80 |
|
64450, 64455, 64632, 64640, 64704, 64774 |
||
Radiology |
73600-73610 |
TC, 26 |
73615 |
26 |
|
73620-73660 |
TC, 26 |
|
Pathology and Laboratory |
81000-81015, 81025-81099, 82108, 82310-82330, 82728, 83015 |
|
83715 |
TC, 26 |
|
84100, 84550, 85007, 85009, 85014-85041, 86316-86318 |
||
86329-86332 |
TC, 26 |
|
87003-87045, 87070, 87075-87076, 87081-87106, 87109-87147, 87158 |
||
87164-87166 |
TC, 26 |
|
87176-87184, 87186-87197, 87205-87206 |
||
87207 |
TC, 26 |
|
87210-87253, 87260-87272, 87274, 87276, 87278, 87280, 87285-87299, 87301-87324, 87328-87335, 87340, 87350-87391, 87420-87425, 87430-87450, 87470-87799 |
||
87999 |
TC, 26 |
|
88230-88239, 88245-88248, 88263, 88269, 88283, 88289 |
||
88358-88362 |
26 |
|
88365 |
||
Medicine |
90782, 90788, 97012-97139, 97597-97598 |
|
99000-99001 |
||
99070, 99199 |
||
Evaluation and Management |
99201-99203, 99211-99213, 99221-99222, 99231-99232, 99234-99239 |
|
99241-99242, 99251-99252, 99261-99262 |
||
99281, 99301-99316, 99341-99350, 99499 |
* May be billed as a bilateral procedure with modifier "50" in Item Number 24D of the 1500 Health Insurance Claim Form.
Service | Healthcare Common Procedure Coding System Codes | Allowable Modifier(s) |
|---|---|---|
Medical and Surgical Supplies |
A4490-A4510, A6244 |
|
Procedures/ Professional Services |
G0127, G0306-G0307 |
|
Drugs Administered Other Than Oral Method |
J0131, J0290, J0295, J0690, J0696, J0697, J0702, J0715, J1020, J1030, J1040, J1094 J1100, J1170, J1642, J1650, J1885, J2001, J2250, J2270, J2405, J2920, J2930, J3010, J3301, J3302, J3420, J3490, J3590, J7120, J9040 |
|
Routine Foot Care |
S0390 |
U1, U2, U3 |
Q Codes (Temporary) |
Q4029-Q4048, Q4101, Q4106 |
|
Temporary National Codes (Non-Medicare) |
S0017-S0021, S0030-S0077, S0081 |
|
S3645-S3650 |
||
S8035 |
TC, 26 |