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Heel Bursitis N044

Document
Last amended 
26 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
77 of 2010
Balance of Probabilities SOP
78 of 2010
Changes from Previous Instruments:

SOP Bulletin 146

ICD Coding:
  • ICD-9-CM Codes: 726.79
  • ICD-10-AM Codes: M76.7

This SOP covers inflammation of the superficial bursa, just under the skin, at the back of the heel.

Is specific evidence required to apply the SOP – No
Are there sub-factors that require specific information? – No
Additional diagnoses covered by SOP
  • Posterior adventitial heel bursitis
  • Haglund’s disease
  • Superficial retrocalcaneal bursitis
Conditions not covered by SOP
  • Achilles peritendonitis, ICD-9-CM code 726.71
  • Deep retrocalcaneal bursitis, ICD-9-CM code 726.71
  • Plantar calcaneal bursitis, ICD-9-CM code 726.79
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Treating practitioner’s report
  • Report from orthopaedic surgeon

There is another bursa, deep to the Achilles tendon, absorbing friction between the tendon and the calcaneal bone.  Bursitis at that site is covered by a separate SOP, Achilles tendinopathy and bursitis (Nos. 37 & 38 of ‘07).