Flat feet are a kind of foot deformity that can either be present at the time of birth or is acquired later in life for different reasons. It can be recognized by the absence of the arch found in the feet. Having a low arch or no arch at all means that your whole feet lay flat on the ground, hence the name ‘flat feet’. In medical terminology, flat feet are called pes planus.
For a medical biller or coder, it is imperative to have a thorough knowledge of the different types and problems associated with the deformity, to ensure that coding is done accurately leading to correct and speedy reimbursement for the medical practice. In this article, that is exactly what we discuss; the different causes leading to flat feet, their types, and the commonly associated ICD 9 code for flat feet.
The process of coding and submitting claims for the medical services provided is documented carefully.
What are Flat feet?
Flat feet, also known as pes planus or fallen arches is a serious deformity with various degrees of physical impact. The condition can be passed down to the next generation as a hereditary trait or it may develop later in life due to various factors. The condition is characterized by no arch which means that the entire sole of the foot touches the ground when standing.
Flat feet are more common in infants, with the major cause being heredity. The condition is identified when the Achilles tendon is tight or from the laxity of ligaments. In children, the condition can develop if there’s a lack of foot exercise.
For adults, flat feet can develop from a foot injury, continued stress on the foot arches, abnormal joint formation, obesity, arthritis, diabetes, or from the tightness of the Achilles tendon.
Identifying Flat Feet
The major identifier for the condition is the lack of arches found in the feet, resulting in pain and fatigue along the inner sides of your feet. Other symptoms to look for include: heel and ankle pain, lower back pain, abnormal walking pattern, rolled in ankles, and shin splints.
Types of flat feet
In general, flat feet are categorized into two groups: Congenital pes planus which is from birth, or acquired flat feet which develop in adulthood. They are further segmented into the following types:
Flexible Flat Feet
This is the most common type in which the arches are visible when a person is not standing, but disappear as soon as they stand up and put weight on their feet. This type develops in early childhood and gets worse gradually with age. Due to the absence of arches, the ligament and tendons in the feet can tear, swell and stretch.
Rigid Flat Feet
A person with rigid flat feet does not have any arches even when they are sitting. This condition develops in the teens and gradually worsens as the person gets older.
A fallen arch is an example of an adult acquired type, where the foot’s arch collapses unexpectedly. This causes the foot to turn outward causing immense pain. A fallen arch can result from inflammation or tear in the leg tendon which supports the foot arch.
This is a congenital disability meaning that babies are born with this deformity that prevents the feet arches from forming altogether. The talus bone, found in the ankle, is in the wrong position.
Coding for Flat Feet ICD 9
Given the two primary types of flat feet, namely congenital and acquired, below are the corresponding codes for each:
Flat Feet (Acquired) – 734
From the 2012 ICD-9-CM, the diagnosis code for acquired flat feet is 734 that can be used to indicate a diagnosis for reimbursement purposes. The code is valid for claims with a date of service before September 2015, since the ICD 9 was effectively replaced by the ICD 10 code after that. The relevant ICD 10 code for 734 is M21.40 Flat foot (acquired).
The code excludes the cases dealing with a congenital flat foot, rigid flat foot, and everted flat foot.
Flat Feet (Congenital) – 754.61
754.61 represents the ICD 9 code for congenital pes planus that can be used to show a diagnosis for reimbursement and claims process. The code is valid for claims with a date of service before September 2015, since the ICD 9 was effectively replaced by the ICD 10 code after that. The relevant ICD 10 code for congenital flat feet is Q66.50 Congenital Flat foot (acquired).
Purpose of Flat Feet ICD 9 Coding
Accurately coding all medical procedures and services is crucial for claims processing and reimbursement. Additional benefits include:
Formally Documenting and Capturing Information about Flat Feet:
ICD 9 codes for flat feet enables medical coders to correctly specify the complete details about the condition, including information such as whether the disability is congenital or acquired and if one foot is affected or both. This helps in maintaining and improving the global data on the condition that helps in research and data collection.
Congenital or Acquired?
One of the most important differentiating factors that need to be highlighted when coding for the condition is whether the patient has acquired or congenital flat feet. This information is imperative for reporting when it comes to coding with ICD.
Keeping in Mind the Exclusions
Another thing to keep in mind when coding for flat feet ICD 9 is to check for the notes mentioned under the specific category. The notes specify the different synonyms for the condition, as well as the exclusions. The coder needs to be careful when coding to avoid any mistake in reporting the diagnosis. If their errors in the reporting and coding, it will definitely cause issues during the claim process, creating hassle for the patient as well as the practice.
Outsourcing Medical Coding and Billing Services
The ICD is considered by healthcare professionals as a universal language through which doctors and healthcare providers communicate regarding the thousands of health conditions and diseases. The codes are expanded each year with frequent inclusions to incorporate as much information as possible. It is for this reason that the accurate reporting of these medical codes is essential for any medical practice or hospital.
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