Hammertoe is a deformity that causes the toe to bend upward at the middle joint. It is more common in women and can affect one or more toes. Symptoms include toe deformity, pain, and difficulty walking. Treatment options range from padding and splints for mild cases to surgery to remove bone prominences for severe cases. The condition is coded using ICD-10 codes depending on whether it is acquired or congenital, and CPT codes if surgery is performed. Outsourcing medical billing and coding services can help podiatrists with reimbursement tasks.

1. www.outsourcestrategies.com 918-221-7769
Hammertoe - Podiatry Treatments
and Coding
Podiatry treatments for hammertoe can be non-invasive or surgical, depending
on the severity of the deformity and associated symptoms.
More common in women than men, hammertoe causes the toe to bend upward at its middle joint.
The California Podiatric Medical Association defines hammertoe as a contracture—or bending—
of the toe at the first joint of the digit, called the proximal interphalangeal joint. The condition
can also occur in one or both joints of the second, third, fourth or fifth (little) toes. For podiatrists
treating such conditions, medical billing outsourcing is a great option to meet their medical
claim submission and reporting tasks.

2. www.outsourcestrategies.com 918-221-7769
Often, patients with conditions such as diabetes, rheumatoid arthritis and neuromuscular
conditions are more likely to develop hammertoe. Mainly caused by abnormal balance of the
muscles in the toes or by heredity, hammertoe can also be the result of -wearing shoes that aren’t
the right size, a toe injury, complication from underlying medical conditions, tightened ligaments
or tendons in the foot or pressure from a bunion. Common symptoms of this condition include
deformity / prominence of toe, pain, redness or swelling around the joints, corn / callous, bent
toes, stiffness in the joints of the toe and difficulty in walking.
Types, diagnosis and treatment
There are two types of hammertoe - rigid and flexible. While flexible hammertoe is still movable
at the joint and is a milder form of the condition, the rigid type will press the joint out of
alignment and the toe can't move. Left untreated, the condition can worsen and become rigid,
leading to severe pain.
Diagnosis for hammertoe will be done by performing a physical examination of the foot to study
the contracture of the toes and by using imaging techniques like X-rays to identify the degree of
the deformity.
Based on the diagnosis, non-surgical treatment options will be considered first, which include -
padding to prevent your toes from rubbing against the shoe and causing sores, taping to change
the imbalance around the toes and thus relieve the stress and pain, splints to keep the toes in the
correct place, medications to reduce swelling and pain and orthotic devices like shoe inserts to
reduce symptoms and prevent the worsening of the hammertoe deformity. If these non-invasive
treatments do not provide results, surgery will be recommended to remove the bony prominence
and restore normal alignment of the toe joint and thus relieve pain.
Along with hammer toe, some people may also have other foot problems, such as bunions, heel
spurs, or corns. Podiatrists may also recommend certain lifestyle changes such as wearing proper
shoes, regular exercise and avoiding heels more than two inches tall.
If hammertoe is not treated, it can get worse and the toes may become rigid, causing pain and
making it hard to walk or wear shoes.

3. www.outsourcestrategies.com 918-221-7769
When it comes to reimbursement of hammertoe treatment, Medicare.gov has reported that
Medicare Part B (Medical Insurance) covers podiatrist foot exams or treatment if you have
diabetes-related nerve damage or need medically necessary treatment for foot injuries or
diseases, like hammer toe, bunion deformities, and heel spurs.
Coding
While reporting and coding the condition, know whether the patient's hammertoe is acquired or
congenital, as the ICD-10 code will change depending on that.
ICD-10 codes for acquired hammertoe include
 M20.4 Other hammer toe(s) (acquired)
 M20.40 Other hammer toe(s) (acquired), unspecified foot
 M20.41 Other hammer toe(s) (acquired), right foot
 M20.42 Other hammer toe(s) (acquired), left foot
If the patient has undergone hammertoe surgery, the possible CPT® code option is 28285.
 28285 Under Repair, Revision, and/or Reconstruction Procedures on the Foot and Toes
Busy physicians and practices can take advantage of podiatry medical billing and coding
services provided by experienced medical billing companies.
Outsource Strategies International
8596 E. 101st Street, Suite H
Tulsa, OK 74133