Plantar Fasciitis ICD-10 codes change from October 01, 2026. These codes are M67.A01 for the right foot, M67.A02 for the left, and M67.A09 when the foot is not specified. Before the mentioned date, the code was M72.2 but it has a new meaning from October 1. This code M72.2 will represent plantar fascial fibromatosis only, which is a different condition. What is the rule that decides the code? The date of service, for sure. If the service is rendered on September 30, M72.2 is used, if the date of service is October 1, it is M67.A0x, irrespective of when the care began. This guide discusses ICD 10 code for plantar fasciitis, billing rules, CPT codes for every treatment, the drug and orthotic codes.
Plantar Fasciitis ICD 10 Code
ICD-10 launched in October 2015, since then, there is no dedicated code for plantar fasciitis ICD 10. It had borrowed the code of plantar fascial fibromatosis, which was M72.2. FY 2027 ICD-10-CM update, effective October 01, 2026, put an end to it.
| Disease | Before October 1, 2026 | From October 1, 2026 |
|---|---|---|
| Plantar fasciitis | M72.2 (shared with plantar fascial fibromatosis, no laterality) | M67.A01 right foot · M67.A02 left foot · M67.A09 unspecified foot |
| Plantar fascial fibromatosis (Ledderhose disease) | M72.2 (same shared code) | M72.20 unspecified · M72.21 right · M72.22 left |
The code split is an important thing to know because the conditions are different from each other. Ledderhose disease is fibrotic, nodular disorder of the fascia and the plantar fasciitis is the inflammatory heel pain podiatrists need to treat in most cases.
Right Plantar Fasciitis ICD 10 and Laterality
The long standing question of coders is whether there is a right plantar fasciitis ICD 10 code or not. Now, there is an answer to this question. M67.A01 is the right and M67.A02 is the left. What’s with the laterality? It is a billing issue and there is a separate code for the unspecified foot, M67.A09. If there is a code present for the specific laterality, billing M67.A09 with the documentation that says right foot, is a chance of claim denial.
M72.2 – Legacy Code and the Date-of-Service Rule
M72.2 itself is deleted, and its subcategory continues as M72.20, M72.21, and M72.22 with a changed meaning. From October 01, M72.2x is used for Ledderhose disease only. A plantar fasciitis visit billed with M72.21 after the date makes it an obsolete code. It becomes the wrong disease after the mentioned date and it will not be a medical necessity for the plantar fasciitis procedure. The date of services decides the code set and the date on which the care started does not determine the code. As the codes are transitioned, so practices will be billing September dates in October and November, so both code sets stay in the system for some time. For crosswalks and GEMs, the notes are required because laterality did not exist before.
Related Codes – Heel Pain and Calcaneal Spur
Pain in the heels is not always due to plantar fasciitis. It often comes with a spur. Two code families are there to cover this scenario. The rule for both code families is that it describes the documentation of the healthcare provider, not what coders suspect. There is no dedicated code for the heel pain in ICD-10-CM.
| Situation | Code | When to use it |
|---|---|---|
| Heel pain, no confirmed cause | M79.671 right · M79.672 left · M79.673 unspecified | Symptom code only; drop it once a diagnosis is documented |
| Calcaneal spur | M77.31 right · M77.32 left · M77.30 unspecified | Add alongside the plantar fasciitis code when imaging shows a spur and the note says so |
A heel spur is a condition that often appears in the X-ray of patients who suffer from plantar fasciitis. This spur is a bony growth on the calcaneus, and this has separate codes: M77.31 for right, and M77.32 for left, and M77.30 for unspecified. This spur is coded with the plantar fasciitis, not instead of it. Two important cases for heel spur are: the imaging should show the spur and the provider has documented it. Laterality is a part of every code family: M67.A0x, M79.67x, M77.3x, and the foot has to match across every code on the claim for accurate payments.
CPT Codes for Plantar Fasciitis Treatment
The treatment of plantar fasciitis follows a ladder which has certain steps. This is the step-wise ladder: visit and imaging, then injection and strapping, then orthotics and splints, the shock wave, then surgery. As we step up, the billing rules become more strict. One thing to keep in mind, every step that needs to get paid should be documented with all the steps below it.
Office Visit and Imaging
| Service | Code | What decides it | Note |
|---|---|---|---|
| Office visit, new patient | 99202–99205 | Medical decision making or total time | — |
| Office visit, established patient | 99211–99215 | Medical decision making or total time | — |
| X-ray, foot, complete | 73630 | Three or more views | Rules out stress fracture; documents a spur |
| X-ray, calcaneus | 73650 | Two or more views | The heel bone specifically |
If the visit was separate and an injection or strapping happens on the same date, -25 modifier is used with E/M. Imaging codes take RT and LT, and the side should match the diagnosis code for accurate claims.
20550 CPT Code: Plantar Fascia Injection
The core code says this: injection, single tendon sheath, or ligament, aponeurosis. The plantar fascia is an aponeurosis. This is the reason why this is the plantar fascia injection code. There are three rules that should be considered:
- One unit for one site irrespective of how many needles pass.
- 20551 is a different structure as it is used for the tendon origin or insertion, it is a common mistake while choosing the code for plantar fascia.
- The steroid is a separate rail. the drug bills by J-code in dose units: J3301 triamcinolone per 10 mg (40 mg = 4 units), J1030 methylprednisolone 40 mg, J1040 methylprednisolone 80 mg, J1100 dexamethasone per 1 mg. A claim with 20550 and no J-code left the drug unbilled.
Ultrasound guidance: 76942 alongside 20550 when guidance is used. 76942 is guidance for the needle, not a diagnostic ultrasound of the foot, which is a separate service. An image is saved and the report is written. The global period of 20550 is zero days.
Strapping, Orthotics, and Night Splints
Once the injection is done, the next step of the ladder is mechanical support. The strapping is done in the patient office and the orthotic devices the patients take with themselves to home.
| Service | Code | Type | Coverage and billing rule |
|---|---|---|---|
| Strapping, ankle and/or foot | 29540 | CPT | 0-day global period; not billed with a cast at the same site |
| Custom foot insert, molded to patient model | L3000 | HCPCS (DME) | Generally not covered by Medicare outside the diabetic therapeutic shoe benefit; commercial or patient-pay for most |
| Night splint — static or dynamic AFO, prefabricated and customized to fit | L4396 | HCPCS (DME) | Order, supplier billing, and documented failure of conservative care |
| Night splint — prefabricated, off-the-shelf | L4397 | HCPCS (DME) | Same DME rules; lower payment than L4396 |
ESWT: 28890 and 0101T
Let’s move to the next step of the ladder. Extracorporeal shock wave therapy (ESWT) is a procedure without incision. This procedure is done in the office. How is the therapy done? A sound-wave pulse is sent inside the foot to plantar fascia from outside the body. This is usually done if the injections and orthotics have not worked.
There are two CPT codes as it is a special case. 28890 is the specific code for the shock wave procedure for plantar fascia, high energy, it requires anesthesia more than a local one. It also includes ultrasound guidance. This code is a code which is permanently established and it has an assigned value.
0101T is a general code and it is a Category III code. It is a shock wave for the musculoskeletal system. When is this used? If the procedure does not meet the terms defined in the 28890 and the target is not plantar fascia. It is a tracking code on a temporary basis for emerging procedures. Lastly, it has no payment assigned to it and there is no coverage by most payers.
What is the selection rule for both? If there is plantar fascia with high energy and anesthesia, 28890 is used. Anything other than this, 0101T is used. For plantar fascia procedure, which qualifies for 28890, do not use 0101T. Also, avoid using 28890 for a low-energy procedure to make it look covered by payers. Even with a permanent code, Medicare generally does not cover ESWT for plantar fasciitis, so Medicare patients sign an Advance Beneficiary Notice before the procedure and pay for it themselves. Commercial coverage varies by plan.
Surgical Codes: CPT 28060, 28062, 28008, 29893
Now, this is the top of the ladder. CPT 28060 is a partial plantar fasciectomy. In this procedure, a part of plantar fascia is removed. For the radical version, 28062 is used. If the fascia is released instead of removing it, 28008 is used. 29893 is an endoscopic plantar fasciotomy. There are two rules important to discuss here: all these codes, four of them, carry a 90-day global period. Thus, routine visits in the case of post operative visits are bundled.
Plantar Fasciitis Billing Rules
Adhering to payer rules is essential part of the clean claims submission of plantar fasciitis. Every procedure code has a global period, which is the number of days after the procedure during which routine follow-up is included in the payment. Medically unlikely edits (MUE) is a cap by Medicare on the number of units of code that you can bill on one date of service. NCCI (National Correct Coding Initiative) edits show a list of codes that can be bundled. Payers cap how many times the service is covered, so frequency limits should be considered. LCD (Local Coverage Determination) is a Medicare contractor’s policy on what it covers and when it covers. LCA (Local Coverage Article) carries the details of billing and coding.
| Rule | What it means | For plantar fasciitis claims |
|---|---|---|
| Global period | Days of follow-up included in a procedure’s payment | 20550 and 29540: 0 days · surgery: 90 days |
| MUE | Max units of a code per date of service | 20550 has a cap; bilateral = 2 units with 50 or RT/LT |
| NCCI edits | Code pairs that bundle | 20550/20551 same site bundle; 76942 pairs with 20550 |
| Frequency limits | How often a service is covered | Steroid injections limited per site per year; document response |
| LCD / LCA | Contractor coverage policy and its billing article | ESWT and L3000 are LCD-governed; injections are not |
| Clean claim (CMS-1500) | Passes first submission | Diagnosis pointer, laterality modifier, J-code line, and date of service all agree |
Common Plantar Fasciitis Billing Denials and How to Prevent Them
- The first is the date of service, as discussed in the beginning of the article. The code M72.2 billed on or after October 01, 2026 does not pay for plantar fasciitis.
- Using unspecified when specific code is present. If the note mentions the foot, using M67.A09 is a denial. Use correct code based on the left or right foot.
- Submitting code for injection but not the drug is a silent revenue loss. Using 20550 without J-code is a financial loss you can avoid by using J-code in dose units in every injection claim.
- 20551 used for plantar fasciitis is an incorrect code that leads to denial. 20550 is the correct code to be used.
- ESWT billed to Medicare without ABN (Advance Beneficiary Notice) on the file. ABN should be signed before the procedure for every Medicare ESWT patient.
- Exceeding the frequency limit leads to claim denials. For instance, the fourth injection in one year. Fix this by following the payer rules.
- Laterality modifier is different than the diagnosis is also a reason for claim denials. So, use accurate modifiers based on the notes.
The coders who manage these claims know exactly where to avoid revenue leakages. Outsourced podiatry billing services exist to help you submit accurate plantar fasciitis claims and help get accurate reimbursements.
