11/24/2024    David J. Freedman, DPM

Billing for Flatfoot (Allen Jacobs, DPM)

The AOFAS has adopted the term “progressive
collapsing foot deformity" in part because of the
difficulty in being reimbursed for a diagnosis of
“flatfoot". Allen Jacobs, DPM, St. Louis, MO

As Chair of the APMA Coding committee, we
submitted an application in May of 2021 to the
National Center for Health Statistics, ICD-10
Coordination and Maintenance Committee
located in Hyattsville, Maryland. We explained
progressive collapsing foot deformity using
clinical references and peer-reviewed literature,
then detail why the organizations deserved its own
set of ICD-10-CM codes. The term “progressive
collapsing foot deformity" has been widely
accepted, evidenced by the fact it already appears
in 16 National Library of Medicine PubMed.gov
search results at the time of the May 2021
request, a startling number given the term was
just introduced in October, 2020.

At the same time, the consensus group advocated
for the use of “progressive collapsing foot
deformity“, it also proposed a new classification
system which had been widely accepted.
Differentiating between flexible and rigid
progressive collapsing foot deformity is an
important component of accurate documentation,
epidemiology, and treatment planning, to name a
few reasons. APMA demonstrated that the current
ICD-10-CM code set does not allow for the
appropriate reporting of progressive collapsing
foot deformity. ICD-10-CM also plays a role in
conducting research, setting health policy,
epidemiology studies, clinical trials, monitoring
resource utilization, improving clinical
performance, tracking public health, designing
healthcare delivery systems, and measuring the
quality, safety, and efficacy of care.

In its current state, the ICD-10-CM code set does
not allow for any of these benefits to be applied
to progressive collapsing foot deformity. The sad
part is we utilized orthopedic literature, we
thought the AOFAS and AAOS were supportive only to
be shot down by these orthopedic societies at the
comment period for the new codes where they were
not in favor for these new code sets. Maybe times
have changed to see if they want to partner with
us again?

David J. Freedman, DPM, Silver Spring, MD

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