Question: Can CPT 27640 be used for bone spur removal at the ankle, for example in the tibia? In the AMA CPT book, CPT 27640 means "Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); tibia"—but can it be used for ankle osteophytes removal from tibia?

Response from Codinghelpline.com:  When reviewing the possible ICD-10-CM Codes expected to fit this CPT code, CPT 27640, these are typically one of the expected diagnoses:

D16.2—Benign neoplasm of long bones of lower limb

M77.5—Other enthesopathy of foot and ankle

M86.16—Other acute osteomyelitis, tibia and fibula

M86.26—Subacute osteomyelitis, tibia and fibula

The following may or may not meet the medical necessity depending on the payor. So, unless one of the above do not meet your diagnosis, then consider one of these but it does not ensure coverage: M25.771 Osteophyte, right ankle or M25.772 Osteophyte, left ankle; M15.0 Primary generalized (osteo)arthritis; M15.3 Secondary multiple arthritis; M15.8 Other polyosteoarthritis; M19.071 Primary osteoarthritis, right ankle and foot; M19.072 Primary osteoarthritis, left ankle and foot; M19.171 Post-traumatic osteoarthritis, right ankle and foot; M19.172 Post-traumatic osteoarthritis, left ankle and foot; M19.271 Secondary osteoarthritis, right ankle and foot; M19.272 Secondary osteoarthritis, left ankle and foot.

—David J. Freedman, DPM, CPC, CSFAC, CPMA

Additional coding and billing questions and responses can be found at www.Codinghelpline.com                          

CMS is expected to release its final calendar year 2027 Medicare Physician Fee Schedule in early November, setting physician pay for Jan. 1, 2027, barring congressional intervention.

The proposed rule, issued July 14, would cut the conversion factor 1.68% for most physicians, slash total joint replacement payment by about 20% and pay half for some same-day visits. It drew 43,040 public comments before the Sept. 14 deadline.

Source: Becker’s ASC Review

If you have had issues with DME enrollment this story may explain some of the reasons. This violation resulted in a $19M recoupment, and both defendants face significant jail time.

The supplier community has applauded the prosecution of these defendants but continues to wonder why it takes so long to catch up on these activities? And, why is the ethical provider (likely you, reading this) forced to face such a difficult time enrolling or re-validating their enrollments?

—Paul Kesselman, DPM

Have you experienced these sort of enrollment and re-validation issues? Let us know.

Diabetic foot ulcers (DFU) are not cured; they are driven into remission. Remission is a temporary state that can potentially end with a single unfortunate step. Clinically, we must collaborate with our patients to provide a safer daily environment for their feet. Such an environment alleviates ulcer risk factors such as changes in pressure, friction, and skin temperature. A multimodal approach with active clinical monitoring and patient adherence can generate improved outcomes such as reduced ulcer recurrence, infection, and amputations. This requires teamwork between the podiatrist and the patient. In this relationship, the podiatrist provides evidence-based information and care to the patient and helps the patient incorporate these evidence-based decisions into their daily lives

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