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Podiatry Coding Alert

Surgical Coding:
Keep Your Os Trigonum Excision Coding Straight for Maximum Benefit
Hint: Look for your podiatrist's note of a posterior tibial impingement. If you can nar... Read more
CPT® 2013:
Make the Most of 'Other Qualified Healthcare Professionals' Billing
Don't limit E/M services to general surgeons in your practice. If you've been losing pa... Read more
Payer Pointers:
Learn the Ropes of 5 Common Audits Your Practice May Face
Understanding several types of audits can help your practice prepare. If you are gettin... Read more
2013 Payment:
Finalized 2013 Fee Schedule Includes 26.5 Percent Cut
Plus: Transition care management pay is formalized with assignment of codes 99495-99496.... Read more
Reader Question:
29450 Describes Weekly Clubfoot Casting
Question: Which modifier should we report when we recast a patient each week to treat hi... Read more
Reader Question:
No FBR? Append Modifier 52 to 10120 or 28190
Question: A patient came to our office after stepping on a nail. He was afraid some mate... Read more
You Be the Coder:
Repeat Nail Procedures
Question: We have a patient who has had both first nails removed and phenolized twi... Read more
CCI Update:
12001-13153: Include Closure in Nearly Every Surgical Procedure
Report repair alone or with lesion excision only.In case you've ever wondered if you could... Read more
CPT® 2013:
Watch for These E/M Descriptor Tweaks in New Year
Will these changes affect your billing?Most podiatrists bill evaluation and management cod... Read more
Billing Corner:
Don't Let No-Shows Mean No Reimbursement
Follow these 4 tips to help cushion the cost.These days every dollar and every minute coun... Read more
News You Can Use:
CMS Makes Revalidation Process Permanent
Plus: Medicare begins accepting faxed, emailed supporting documents.If CMS's revalidation ... Read more
Reader Question:
11055-11057 Should Not Be Doubled
Question: My podiatrist had a patient with one hyperkeratotic lesion on the left foot and ... Read more
Reader Question:
28041 or 28045? Choice Depends on Size
Question: Our podiatrist did an open excision of a lipomatosis nodule of the sinus tarsi o... Read more
Reader Question:
ICD-9 Freeze Will Spare You New Updates This Year
Question: Are there any ICD-9-CM updates planned for 2013? Iowa Subscriber Answer: No ICD-... Read more
You Be the Coder:
Tendon Repair
Question: How should I code the repair of two extensor digitorum longus tendons (right foo... Read more
Unna Boots:
29580 Basics: Give Unna Denials the Boot
Follow our experts' 6 simple steps for strapping success.With just one CPT® code&nbs... Read more
E/M Corner:
Follow 3 Steps to Proper MDM Determinations
Our experts' system can help you calculate each individual piece of the medical decision m... Read more
Fracture Care Coding:
29550 or 28490? Find the Right Fracture Code for the Case
You could be missing more than $100 in deserved reimbursement.How can you tell if a claim ... Read more
News You Can Use:
Double-Digit Cuts May Strike Your Income Starting in January
Some specialties could suffer if Congress doesn't step in.Every year around this time, the... Read more
Reader Question:
28296 and 64450 Are Inseparable
Question: I billed 28296 for a bunion correction with metatarsal osteotomy, and 64450 for ... Read more
Reader Question:
28450 Can Apply, Even Without Manipulation
Question: Our physician saw a patient for a non-displaced tarsal bone fracture, which did ... Read more
You Be the Coder:
Jones Fracture
Question: A podiatrist in my practice listed Jones fracture as the patient's diagnosi... Read more
X-rays:
See Through X-Ray Rules to Visualize Proper Coding
Using foot and toe modifiers correctly can be the key to reimbursement. Even beginning co... Read more
Coding Case:
28285 With 28232? Use Caution When Reporting the 2 Together
Our expert advice helps you ace your tenotomy with hammertoe correction claims. Think twi... Read more
Billing Corner:
Overcome Primary vs. Secondary Payer Woes with Answers to Your FAQs: Part 2
Tackle payment errors like a pro with this advice. Collecting payment for patients who ar... Read more
Reader Question:
Consider Coding Chemocauterization
Question: A patient came in for wart removal on his right second toe. The physician perfo... Read more
Reader Question:
Know When You Can Bill the Patient Directly
Question: I need to know if I can bill a patient for a supply (crutches) and not bill the... Read more
You Be the Coder:
Metatarsal Delayed Union
Question: A patient was treated for a fracture of the second metatarsal. Four weeks later... Read more
Surgery:
28285, 28315 Plus Proper Modifiers Equals Partial Sesamoidectomy and Hammertoe Claim Success
Open up your sesamoid coding options with these 3 tips.Coding for hammertoe correction and... Read more
Collections:
Patients Reluctant to Provide SSNs? Follow These Tips to Keep Billing on Track
Answer privacy concerns while keeping a firm payment policy in place.As the stories of ide... Read more
Denial Management:
Make Sure Practitioner Specialty Codes Are Accurate
Tip: Check with your MAC to make sure your physicians are entered properly.If you report a... Read more
Compliance:
Is Your Practice Leaning Too Heavily Toward High-Level E/Ms?
Warning: The OIG is scrutinizing your 99214 and 99215 trends -- make sure you are, to... Read more
Reader Question:
77002 Documents Fluoroscopic Guidance
Question: My podiatrist performed a plantar nerve destruction to treat pain from Morton's ... Read more
Reader Question:
V67.00 Accurately Describes Follow-Up After Surgery
Question: If a patient receives treatment and the condition was resolved, which ICD-9 code... Read more
Reader Question:
Include Class Findings in Onychomycosis Claim
Question: During his initial visit, a new diabetic patient (250.7x) complaining of foot pa... Read more
You Be the Coder:
Gout Excision
Question: Our podiatrist recently excised a soft tissue mass from the foot of a patient su... Read more
Lesion Removals:
701.1 Is Your Best Bet for Porokeratotic Lesions
CPT 11055, 11420, or 17000? Your coding will depend on the method used. There may be ... Read more
Evaluation and Management:
99212 or 99213? MDM Level Is Key to Understanding Podiatry E/M Claims
Hint: Assign tips to each of the 3 MDM components your podiatrist performs. Your podia... Read more
Billing Basics:
Avoid 10 Common Billing Errors With 10 Expert Tips
Hint: Benefits verification can solve a lot of your denial problems.What's the top tool in... Read more
Reader Question:
Identify the Osteomyelitis Organism
Question: Which diagnosis codes should I use for chronic osteomyelitis of the third metata... Read more
Reader Question:
Count Prescriptions as Part of E/M
Question: My podiatrist heard that there's a code we can bill and be paid on just for the ... Read more
Reader Question:
Ensure That Diagnosis Matches Patient's Condition
Question: When I bill Medicare for deep debridement (11042) using the diagnosis the physic... Read more
Reader Question:
Insurers May Require Bundling Same-Day E/M Services
Question: Can we bill two office visits on the same day? We reported 99214 twice for the s... Read more
You Be the Coder:
Hallux Limitus Release With Bunionectomy
Question: Can I report a hallux limitus release and an Austin bunionectomy in the same ses... Read more
Gait Analysis:
96000-96004 Survival Guide: 3 Simple Rules for Claims Success
Hint: Don't bill the gait analysis code if the podiatrist only performed one component of ... Read more
Compliance:
OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes
Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period.If you exam... Read more
Billing:
Overcome Primary vs. Secondary Payer Woes With Answers to Your FAQs
Start with the basics and then move on to learning the intricacies.When a patient is cover... Read more
Follow These CMS Rules for Submitting Medicare Secondary Payer Claims
Hint: Copy all beneficiary insurance cards, not just the Medicare one.When Part B practice... Read more
ICD-10 Delay:
Anticipate 1 Extra Year for Your ICD-10 Implementation Schedule
But don't count on the delay quite yet, expert warns.As part of a proposed rule to adopt a... Read more
Reader Question:
Identify Ulcers by Type, Not Depth
Question: Is there a method of correlating Wagner's ulcer classification to ICD-9 and CPT&... Read more
Reader Question:
Report 11740 for Draining Toenail Hematoma
Question: A patient visited our office because of a hematoma under her toenail. The podiat... Read more
Reader Question:
How Should You Bill Medicare?
Question: We are participating with Medicare. We bill and submit claims to Trailblazer (J4... Read more
Reader Question:
No History? Don't Assume Comprehensive Level
Question: Our physician admitted someone as an initial inpatient, but couldn't get all her... Read more
You Be the Coder:
Diabetic Foot Exam
Question: What are the guidelines for performing and coding a comprehensive diabetic foot ... Read more
Toe Repairs:
28290-28299: Know These Terms to Zero In on Proper Bunionectomy Code
With over 100 named hallux valgus procedures, here's what to look for in the procedure not... Read more
Modifiers:
3 Tips Distinguish 58 and 78 to Impact Your Bottom Line
Same condition or complication makes the difference.Choosing the appropriate global-period... Read more
Billing:
Evaluate Your Billing Procedures With Internal Audits, Before an Outside Auditor Does
Starting with a baseline audit will set your practice up for success.Would you pass an aud... Read more
Reader Question:
Distinguish Pain Killing Agents in Plantar Injections
Question: Our clinic has a number of patients seeking treatment for pain in the sole of th... Read more
Reader Question:
No Documented HPI Leads to No Coding for New Patient
Question: A new patient visits the podiatrist with a chief complaint. I don't have a revie... Read more
Reader Question:
Double Check Copay Early to Save Time, Money
Question: A patient came to our office with the same insurance card she's had for years. W... Read more
Reader Question:
Save Initial NF Visit Billing for the Physician
Question: I am receiving denial C0-170 (Payment is denied when preformed/billed by this ty... Read more
You Be the Coder:
Achilles Tear
Question: What is the correct ICD-9 code for a tear of the Achilles tendon?Connecticu... Read more
Modifier 78:
Case Study: Reason Determines Correct Modifier for Metatarsal Excision
Returning a patient to the OR? Read this before assigning a code for multi-step procedures... Read more
ICD-10:
ICD-10 Date Will Be Postponed, HHS Confirms
Delay could offer practices additional time to prepare for new diagnosis coding system.Jus... Read more
HIPAA:
With Audits Heating Up, Is Your Practice Ready?
Make sure your privacy and security practices are up-to-date.If your HIPAA protocols fall ... Read more
Billing Primer:
Considering Going Out of Network? Follow These 3 Tips to Pave the Road to Success
Be honest with your patients to ensure a smooth transition.More and more providers are que... Read more
Reader Question:
10060-10061 Distinction Goes Beyond Packing
Question: Would you clarify the difference between a simple and complex incision and drain... Read more
Reader Question:
Tread Carefully When Dealing With Tarsal Fractures
Question: My podiatrist saw a patient in the emergency department for a non-displaced tars... Read more
Reader Question:
Save Initial NF Visit Billing for the Physician
Question: I am receiving denial C0-170 (Payment is denied when preformed/billed by this ty... Read more
Reader Question:
Does Ability to Bill the Patient Expire?
Question: Is there a time limit on when you can bill a patient for their balance due after... Read more
You Be the Coder:
Tarsal Tunnel Release
Question: I have a rough op note that describes an incision behind the ankle to relieve pr... Read more
Nail Debridement:
11720-11721 With E/M? Follow These Tips for Clean Coding
Are these myths costing you $70 per procedure? Auditors look unkindly on podiatry offices ... Read more
Part B Update:
Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012
Plus: Claims reprocessing has completed, so make sure your claims have been corrected.As m... Read more
Fee Schedule Update:
Expect 2-Month Medicare Payment Reprieve
SGR formula fix is key.You won't face a 27 percent Medicare pay cut beginning Jan. 1 after... Read more
Workers' Compensation:
5 Guidelines Ease the Pain of Billing Workers' Compensation
If you don't get pertinent information before seeing the patient, expect trouble when you ... Read more
Reader Question:
28285-28286 Work for Both Hammer and Claw
Question: How should I code for a claw toe surgery with a tendon transfer? Is it the same ... Read more
Reader Question:
99241-99255: Keep Consults When Possible
Question: Can we still use "consult" E/M codes?North Carolina SubscriberAnswer:  The ... Read more
Reader Question:
Pay Attention to Month, Not Year, With Birthday Rule
Question: I just received a call from a patient's parent claiming that we didn't follow th... Read more
You Be the Coder:
Treatment of Morton's Neuroma
Question: What are the proper codes for a sclerosing injection for the treatment of Morton... Read more
CCI 18.0 Update:
Include 29582 in All Fracture, Dislocation
Look for different sessions or sites before you try to break these bundles. If your podiat... Read more
Medicare Errors:
Providers Underbilled More Than $1 Billion to Medicare in 2010
CERT results reveal $34.3 billion in improper Medicare payments -- $1.1 billion of wh... Read more
CPT® 2012:
Don't Miss These Clarifications About New Patients and 'Qualified Healthcare Professional'
See how changes affect your use of 99201-99205, 99460-99461, and more. Coding guidelines c... Read more
Payer Participation:
4 Tips Help You Successfully Collect for Services When Your Practice Does Not Participate
Hint: Collecting early is often the key.As payer contracts get more and more complicated a... Read more
Reader Question:
Do Not Report Casts Independently
Question: When correcting club feet by releasing the Achilles and then applying the cast d... Read more
Reader Question:
Base Billing Order on RVU Order
Question: I know that as a general rule the highest RVU has a higher billed amount and tha... Read more
You Be the Coder:
Cuboid Syndrome
Question: How should I code for cuboid syndrome and its treatment through manipulation? Wh... Read more
Wound Care:
1101x, 28485 Tell Accidental Foot GSW Story
Also: Got ulcer care, Dermagraft, and VAC questions? Read on for our expert wound care ans... Read more
ICD-10 Bridge
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be differe... Read more
Medical Necessity:
3 Steps Focus Diagnosis Coding for Your Surgical Claims
Add these tips to your ICD-9 toolbox.You won't get paid for your podiatrist's work if you ... Read more
E/M:
HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities
Beware of CPT® and Medicare differences when counting HPI elements.Not accurately ac... Read more
Reader Question:
Diagnosis Is Related to E/M Level, But Doesn't Dictate Code
Question:  Our podiatrist saw an established patient with chronic diabetes. The patie... Read more
Reader Question:
Modifier 55 Won't Apply to Suture Removal
Question:  An established patient went to the emergency room in another state over th... Read more
Reader Question:
Know GC Rules for Resident Surgical Assists
Question: When a resident assists a surgeon in a teaching hospital, do we need to add modi... Read more
Reader Question:
Verify Copay Early to Save Time, Money
Question: A patient came to our office with the same insurance card she's had for years. W... Read more
You Be the Coder:
T3 Skinplasty
Question: What is the proper code for a skinplasty on an overlapping fourth toe on th... Read more
Available Years:  2012  2011  2010  2009  

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