Article Detail - JE Part A
Billing and Coding: Routine Foot Care (A57954) - R20 - Effective October 1, 2025
Date Posted: November 20, 2025
This Billing and Coding article has been revised and published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).
Effective Date: October 1, 2025
Summary of Article Changes: Under ICD-10 codes that Support Medical Necessity Group 2, added an asterisk (*) to the following diagnosis codes: G35.A, G35.B1, G35.B2, G35.C1, G35.C2.
Added clarifying statement to Group 5 Paragraph stating: In the absence of pain caused by the mycotic toenail, the treating provider must clearly state what other impediment is being addressed by the treatment in accordance with the requirements set forth in the Internet Only Manual, 102, Chapter 15 Section 290, Section C (4).
This revision is effective 10/01/2025.
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