Medicare Compliance & Reimbursement

The HHS Office of Inspector General (OIG) added another Part B item to its Work Plan.

Though CMS does cover medically necessary foot and lower leg care related to injuries and diseases, “Part B generally does not cover routine foot-care services such as the cutting or removal of corns and calluses or trimming, cutting, clipping, or debridement (i.e., reduction of both nail thickness and length) of toenails,” said OIG. However, submissions that prove medically necessary for things like wart removal and infection may be covered under podiatry and ancillary services, the OIG Work Plan noted.

Problem: The federal watchdog has noticed an uptick in “inappropriate payments” for this type of podiatric care and ancillary services.

The agency reminds that CMS usually doesn’t pay for E/M services on the same day as podiatry services — unless “an E/M service may be covered if it is a significant separately identifiable service.”

Review the OIG Work Plan’s list of recently added items at https://oig.hhs.gov/reports-and-publications/workplan/updates.asp.