Podiatry Coding Alert
Diabetic Shoes:
Decode Your Diabetic Shoe Denials With These Simple Tips
Make sure not to exceed the limit set for the individual per calendar year. Diabetics ... Read more
Decode Your Diabetic Shoe Denials With These Simple Tips
Make sure not to exceed the limit set for the individual per calendar year. Diabetics ... Read more
Payer Review:
Make Optimum Use of Modifier 50 for Maximum Returns
Avoid combined use of modifier 50 and also LT or RT in the same claim. Don’t get... Read more
Make Optimum Use of Modifier 50 for Maximum Returns
Avoid combined use of modifier 50 and also LT or RT in the same claim. Don’t get... Read more
Modifier News:
Put Your Foot Care Claims in the Fast Lane with Q7-Q9 Modifiers
Make certain that documentation reflects systemic condition with exhibited symptoms or f... Read more
Put Your Foot Care Claims in the Fast Lane with Q7-Q9 Modifiers
Make certain that documentation reflects systemic condition with exhibited symptoms or f... Read more
Readers Question:
Backup Final Diagnosis with Documented Proof to Avoid Rebounds
Question: If the physician hasn’t indicated x-ray results in his final diagno... Read more
Backup Final Diagnosis with Documented Proof to Avoid Rebounds
Question: If the physician hasn’t indicated x-ray results in his final diagno... Read more
Reader Question:
Mind Your Modifiers While Coding Debridement and Trimming
Question: Our podiatrist recently attended to a patient who had diabetes with neuro... Read more
Mind Your Modifiers While Coding Debridement and Trimming
Question: Our podiatrist recently attended to a patient who had diabetes with neuro... Read more
You Be the Coder:
Distinguish Between Destruction and Biopsy for Best Payment Opportunities
Question: Our podiatrist recently attended to patient with suspected malignant grow... Read more
Distinguish Between Destruction and Biopsy for Best Payment Opportunities
Question: Our podiatrist recently attended to patient with suspected malignant grow... Read more
Foot Care:
3 Tips Dispel Your Doubts for Routine Care of Diabetic Neuropathy Patients
Check your local allowed primary diagnostic codes to ensure timely reimbursement. You kno... Read more
3 Tips Dispel Your Doubts for Routine Care of Diabetic Neuropathy Patients
Check your local allowed primary diagnostic codes to ensure timely reimbursement. You kno... Read more
Industry Notes:
CMS Reveals ICD-10 Testing Dates
Self-disclosure clause built in to nip fraud in the bud. As promised, the Centers for ... Read more
CMS Reveals ICD-10 Testing Dates
Self-disclosure clause built in to nip fraud in the bud. As promised, the Centers for ... Read more
Documentation:
Prep Your Paperwork Diligently to Ensure Deserved Payouts
Get ready for even more specificity in ICD-10 next year. You may be able to choose dia... Read more
Prep Your Paperwork Diligently to Ensure Deserved Payouts
Get ready for even more specificity in ICD-10 next year. You may be able to choose dia... Read more
ICD-10 Update:
Keep This Key Handy for Hassle-Free Heel Bone Fracture Reporting
Get ready to query your physician in depth for getting the right diagnosis. Frac... Read more
Keep This Key Handy for Hassle-Free Heel Bone Fracture Reporting
Get ready to query your physician in depth for getting the right diagnosis. Frac... Read more
Readers Query:
Don't Confuse Between Similar Toenail Removal Procedures
Question: A patient had an ingrown toenail removed, but it was not a permanent remo... Read more
Don't Confuse Between Similar Toenail Removal Procedures
Question: A patient had an ingrown toenail removed, but it was not a permanent remo... Read more
You Be the Coder:
Subscribe to the 60/30 Rule for Prolonged Services
Question: My podiatrist recently attended an established diabetic patient with prio... Read more
Subscribe to the 60/30 Rule for Prolonged Services
Question: My podiatrist recently attended an established diabetic patient with prio... Read more
Warts:
Reporting 17110-17111? Kick Denials to the Curb by Avoiding These 3 Major Pitfalls
Here’s what to do when your podiatrist wants to biopsy as well as destroy a wart.&... Read more
Reporting 17110-17111? Kick Denials to the Curb by Avoiding These 3 Major Pitfalls
Here’s what to do when your podiatrist wants to biopsy as well as destroy a wart.&... Read more
Prolonged Services:
Earn Extra Bucks for E/M Services With Prolonged Services Codes
Document accurate E/M time to get maximum deserved reimbursement. Whenever your clinic... Read more
Earn Extra Bucks for E/M Services With Prolonged Services Codes
Document accurate E/M time to get maximum deserved reimbursement. Whenever your clinic... Read more
Compliance:
Avoid Auditing Traps by Following These 3 Lessons
Hint: Most Medicaid audits don’t result in a physician being hauled off to prison.... Read more
Avoid Auditing Traps by Following These 3 Lessons
Hint: Most Medicaid audits don’t result in a physician being hauled off to prison.... Read more
ICD-10 Update:
Confirm the Type of Visit to Code Contusions of the Foot
Differentiate between bruises due to trauma and those due to contusion for correct codin... Read more
Confirm the Type of Visit to Code Contusions of the Foot
Differentiate between bruises due to trauma and those due to contusion for correct codin... Read more
Readers Query:
Watch Out for Global Periods Before Reporting Follow-Up Visits
Question: My physician removed lesions from the right foot of a patient 15 days bac... Read more
Watch Out for Global Periods Before Reporting Follow-Up Visits
Question: My physician removed lesions from the right foot of a patient 15 days bac... Read more
Reader Query:
Extent of Procedure Decides Tendon Repair Code
Question: Our physician performed the following: Primary Repair: split t... Read more
Extent of Procedure Decides Tendon Repair Code
Question: Our physician performed the following: Primary Repair: split t... Read more
Reader Query:
Double Check Documentation Before Using 28755 Blindly for Hammer/Mallet Toe Procedure
Question: Our physicianperformed hammer toe corrections on 2nd, 3rd, 4th, and 5th ... Read more
Double Check Documentation Before Using 28755 Blindly for Hammer/Mallet Toe Procedure
Question: Our physicianperformed hammer toe corrections on 2nd, 3rd, 4th, and 5th ... Read more
You Be the Coder:
Opt for the Most Specific Modifier in Paired Organ Procedures
Question: Our physician is performing a bunionectomy procedure and does not want us... Read more
Opt for the Most Specific Modifier in Paired Organ Procedures
Question: Our physician is performing a bunionectomy procedure and does not want us... Read more
Lisfranc Procedures:
Optimize Your Lisfranc Op Note With This Advice Before You Code Another Claim
If your Medicare carrier requires modifier 76 instead of 59, here’s what to do. ... Read more
Optimize Your Lisfranc Op Note With This Advice Before You Code Another Claim
If your Medicare carrier requires modifier 76 instead of 59, here’s what to do. ... Read more
ICD-10:
Diagnosis Options Open Up for Open Dislocation Codes
Specify code by which foot and toes are affected, as well as initial, subsequent, or seq... Read more
Diagnosis Options Open Up for Open Dislocation Codes
Specify code by which foot and toes are affected, as well as initial, subsequent, or seq... Read more
Payment:
Look For Proposed CMS Global Period Overhaul
You could charge separate E/M, in many cases. A big surprise hit the presses in a rece... Read more
Look For Proposed CMS Global Period Overhaul
You could charge separate E/M, in many cases. A big surprise hit the presses in a rece... Read more
Modifiers:
CMS Debuts 4 New Modifiers to Substitute for 59
Medicare will still accept modifier 59, but use the new modifiers instead when applicabl... Read more
CMS Debuts 4 New Modifiers to Substitute for 59
Medicare will still accept modifier 59, but use the new modifiers instead when applicabl... Read more
ICD-10:
These 3 ICD-10 Answers May Surprise You
Hint: Forget everything you know about ICD-9’s ‘excludes’ codes after ... Read more
These 3 ICD-10 Answers May Surprise You
Hint: Forget everything you know about ICD-9’s ‘excludes’ codes after ... Read more
Reader Question:
Use Caution With Write Offs
Question: At what point can we write off a patient balance as bad debt? Are there certai... Read more
Use Caution With Write Offs
Question: At what point can we write off a patient balance as bad debt? Are there certai... Read more
You Be the Coder:
FB Removal
Question: Our clinic performed minor surgery on a patient to remove a metal fragmen... Read more
FB Removal
Question: Our clinic performed minor surgery on a patient to remove a metal fragmen... Read more
FAQ:
Don't Get Wound Up in Improper Strapping Coding
Tip: Get to know when you can code fracture care instead of just strapping. With schoo... Read more
Don't Get Wound Up in Improper Strapping Coding
Tip: Get to know when you can code fracture care instead of just strapping. With schoo... Read more
ICD-10:
Open Toe Wound With Nail Damage
Three ICD-9 codes will turn into dozens of options under ICD-10. As we mentioned in a ... Read more
Open Toe Wound With Nail Damage
Three ICD-9 codes will turn into dozens of options under ICD-10. As we mentioned in a ... Read more
CCI Update:
Beware Hospital Outpatient Clinic Bundles
G0643 edits affect more than 5,000 codes. Sometimes you’ll see a lull in new Cor... Read more
Beware Hospital Outpatient Clinic Bundles
G0643 edits affect more than 5,000 codes. Sometimes you’ll see a lull in new Cor... Read more
Documentations:
Avoid Faltering on Signature Rules & Exceptions With These 3 Useful Tips
Analyze CMS’s requirements or you risk the wrong use of signatures. If you are n... Read more
Avoid Faltering on Signature Rules & Exceptions With These 3 Useful Tips
Analyze CMS’s requirements or you risk the wrong use of signatures. If you are n... Read more
Reader Question:
Learn The Method to Determine Reimbursement Using RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app... Read more
Learn The Method to Determine Reimbursement Using RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app... Read more
Reader Question:
Turn to Unlisted E/M If Visit Doesn't Match Key Element Requirements
Question: Can I use modifier 52 on 99201 if my provider only captures history and M... Read more
Turn to Unlisted E/M If Visit Doesn't Match Key Element Requirements
Question: Can I use modifier 52 on 99201 if my provider only captures history and M... Read more
You Be the Coder:
Sinus Tarsi Injection
Question: I recently received a denial for a cortisone injection to the sinus tarsi... Read more
Sinus Tarsi Injection
Question: I recently received a denial for a cortisone injection to the sinus tarsi... Read more
Nail Treatments:
Keep Ingrown Toenail Confusion from Irritating Your Claims
Key: Distinguish 11730, 11750 and 11765 from routine foot care. As a podiatry practice... Read more
Keep Ingrown Toenail Confusion from Irritating Your Claims
Key: Distinguish 11730, 11750 and 11765 from routine foot care. As a podiatry practice... Read more
ICD-10:
Open Toe Wound Coding Gets Much More Specific in 2015
Three ICD-9 codes will turn into dozens of options under ICD-10. The diagnosis codes f... Read more
Open Toe Wound Coding Gets Much More Specific in 2015
Three ICD-9 codes will turn into dozens of options under ICD-10. The diagnosis codes f... Read more
Compliance:
OIG Considers Expanding Civil Monetary Penalties
You could be subject to penalties for five additional reasons if the proposal is finaliz... Read more
OIG Considers Expanding Civil Monetary Penalties
You could be subject to penalties for five additional reasons if the proposal is finaliz... Read more
HIPAA:
Let This Example Show You What Not to Do With Your BAs
Warning: You can be responsible for your BA’s violations. Your practice has a so... Read more
Let This Example Show You What Not to Do With Your BAs
Warning: You can be responsible for your BA’s violations. Your practice has a so... Read more
Reader Question:
Slow Patient Won't Justify Timely Filing Exception
Question: Our patient gave us her Medicare card but said Medicare was her secondary... Read more
Slow Patient Won't Justify Timely Filing Exception
Question: Our patient gave us her Medicare card but said Medicare was her secondary... Read more
Reader Question:
Don't Get Too Comfortable With Blanket ABNs
Question: I recently started working at a practice that I think overuses ABNs... Read more
Don't Get Too Comfortable With Blanket ABNs
Question: I recently started working at a practice that I think overuses ABNs... Read more
You Be the Coder:
Anterior Tibialis Tendon Repair
Question: How would I code for the repair of the anterior tibialis tendon in the fo... Read more
Anterior Tibialis Tendon Repair
Question: How would I code for the repair of the anterior tibialis tendon in the fo... Read more
Hyperkeratosis:
Distinguish Corn and Callus Parings from Routine Care
Documenting diagnoses and findings can help you get deserved reimbursement. Paring or ... Read more
Distinguish Corn and Callus Parings from Routine Care
Documenting diagnoses and findings can help you get deserved reimbursement. Paring or ... Read more
ICD-10:
Options Expand for Open Wounds of Foot and Ankle
New diagnosis codes will distinguish which foot and what type of wound it suffered. Po... Read more
Options Expand for Open Wounds of Foot and Ankle
New diagnosis codes will distinguish which foot and what type of wound it suffered. Po... Read more
News You Can Use:
CMS Answers ICD-10 Questions -- By Not Answering
Representatives stay mum about the details of the delay. The recent delay of ICD-10 un... Read more
CMS Answers ICD-10 Questions -- By Not Answering
Representatives stay mum about the details of the delay. The recent delay of ICD-10 un... Read more
Advance Beneficiary Notices:
Know These 4 Categories of Noncovered Services
Sometimes it can be hard to determine what’s considered ‘noncovered.’ ... Read more
Know These 4 Categories of Noncovered Services
Sometimes it can be hard to determine what’s considered ‘noncovered.’ ... Read more
Reader Question:
97760 Is Appropriate for Orthotics
Question: What’s the proper code to report for dispensing and fitting of orthotics... Read more
97760 Is Appropriate for Orthotics
Question: What’s the proper code to report for dispensing and fitting of orthotics... Read more
Reader Question:
Focus on 'Incident-to' Rules
Question: The following scenario occurred in our practice: Physician A covered an e... Read more
Focus on 'Incident-to' Rules
Question: The following scenario occurred in our practice: Physician A covered an e... Read more
Reader Question:
Tackle UB-04 vs. CMS-1500 Dilemma
Question: I used to bill for a facility and am new to the role of practice manager ... Read more
Tackle UB-04 vs. CMS-1500 Dilemma
Question: I used to bill for a facility and am new to the role of practice manager ... Read more
You Be the Coder:
Repeat 11750
Question: Our podiatrist performed a partial excision of the matrix of the lateral ... Read more
Repeat 11750
Question: Our podiatrist performed a partial excision of the matrix of the lateral ... Read more
Ankle Fracture FAQ:
Don't Let Coding Confusion Fracture Your Ankle Claims
Knowing the answers to these frequently asked questions could mean over $70 to your prac... Read more
Don't Let Coding Confusion Fracture Your Ankle Claims
Knowing the answers to these frequently asked questions could mean over $70 to your prac... Read more
Reimbursement:
24 Percent Medicare Pay Cut Averted
Expect level pay through March 31, 2015. You’re probably used to this by now sin... Read more
24 Percent Medicare Pay Cut Averted
Expect level pay through March 31, 2015. You’re probably used to this by now sin... Read more
ICD-10:
Make the Most of the ICD-10 Extension With These Quick Tips
New implementation date has not been announced, but be ready. Whether you’re che... Read more
Make the Most of the ICD-10 Extension With These Quick Tips
New implementation date has not been announced, but be ready. Whether you’re che... 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 complica... Read more
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 complica... Read more
Reader Question:
Don't Bill Separately for K-Wire Removal
Question: A podiatrist in our office just did a hammertoe correction using an inter... Read more
Don't Bill Separately for K-Wire Removal
Question: A podiatrist in our office just did a hammertoe correction using an inter... Read more
Reader Question:
Assess Risk on a Regular Basis
Question: We are having a bit of a debate in our practice. Some of us think that pe... Read more
Assess Risk on a Regular Basis
Question: We are having a bit of a debate in our practice. Some of us think that pe... Read more
You Be the Coder:
Gait Analysis
Question: I’ve had trouble billing for motion analysis codes when our podiatr... Read more
Gait Analysis
Question: I’ve had trouble billing for motion analysis codes when our podiatr... Read more
FAQ:
Clear Up Your Unna Boot Coding Confusion
Find out when you can report an E/M separately. Don’t assume that you have all y... Read more
Clear Up Your Unna Boot Coding Confusion
Find out when you can report an E/M separately. Don’t assume that you have all y... Read more
News You Can Use:
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision. Th... Read more
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision. Th... Read more
Documentation:
Adopt 7 Documentation Best Practices for Compliant and Complete Records
While the provider captures notes just once, they may be reviewed countless times. Whe... Read more
Adopt 7 Documentation Best Practices for Compliant and Complete Records
While the provider captures notes just once, they may be reviewed countless times. Whe... Read more
Reader Question:
28296 and 64450 Are Inseparable
Question: I billed 28296 for a bunion correction with metatarsal osteotomy, and 644... Read more
28296 and 64450 Are Inseparable
Question: I billed 28296 for a bunion correction with metatarsal osteotomy, and 644... Read more
Reader Question:
28450 Can Apply, Even Without Manipulation
Question: Our physician saw a patient for a non-displaced tarsal bone fracture, whi... Read more
28450 Can Apply, Even Without Manipulation
Question: Our physician saw a patient for a non-displaced tarsal bone fracture, whi... Read more
Reader Question:
Explore Options to Enhance Patient Privacy
Question: Are there specific guidelines that our surgical group should follow to pr... Read more
Explore Options to Enhance Patient Privacy
Question: Are there specific guidelines that our surgical group should follow to pr... Read more
Reader Question:
Consider a Flexible No-Show Policy
Question: During the snow storm last month, we had several patients call in and say... Read more
Consider a Flexible No-Show Policy
Question: During the snow storm last month, we had several patients call in and say... Read more
You Be the Coder:
Plantar Fasciitis Injections
Question: What’s the correct CPT® code to report for a plantar fasciitis ... Read more
Plantar Fasciitis Injections
Question: What’s the correct CPT® code to report for a plantar fasciitis ... Read more
Toe Repair Coding Quiz:
Make Sure Bunionectomy Coding Toes the Line
How well do you know your hallux valgus procedures? Compare your answers with our expert... Read more
Make Sure Bunionectomy Coding Toes the Line
How well do you know your hallux valgus procedures? Compare your answers with our expert... Read more
Medicare Pay:
3 FAQs Update Your Fee Schedule Know-How
Get the latest on the 2014 CF, the SGR formula, and sequestration cuts. The New Year b... Read more
3 FAQs Update Your Fee Schedule Know-How
Get the latest on the 2014 CF, the SGR formula, and sequestration cuts. The New Year b... Read more
Modifiers:
Master Modifier 25 Following These Expert Tips
Haphazardly using 25 on all claims will lead to payer scrutiny. With payers cracking d... Read more
Master Modifier 25 Following These Expert Tips
Haphazardly using 25 on all claims will lead to payer scrutiny. With payers cracking d... Read more
Reader Question:
Several Dx Codes Describe Metatarsal Delayed Union
Question: A patient was treated for a fracture of the second metatarsal. Four weeks... Read more
Several Dx Codes Describe Metatarsal Delayed Union
Question: A patient was treated for a fracture of the second metatarsal. Four weeks... Read more
Reader Question:
Incomplete Claims Equal Denials
Question: Our practice has a few claims that have missing or incorrect information.... Read more
Incomplete Claims Equal Denials
Question: Our practice has a few claims that have missing or incorrect information.... Read more
You Be the Coder:
Plantar Injections
Question: Our clinic has a number of patients seeking treatment for pain in the bal... Read more
Plantar Injections
Question: Our clinic has a number of patients seeking treatment for pain in the bal... Read more
Nail Debridement:
Coding E/Ms With Debridement? Read This First
Don’t let coding myths cause you to pass up legitimate opportunities. Auditors l... Read more
Coding E/Ms With Debridement? Read This First
Don’t let coding myths cause you to pass up legitimate opportunities. Auditors l... Read more
Compliance:
Focus on 5 Areas for Improvement in Your Provider Documentation
While EMRs improve legibility, they may lead to other issues. When your practice faces... Read more
Focus on 5 Areas for Improvement in Your Provider Documentation
While EMRs improve legibility, they may lead to other issues. When your practice faces... Read more
E/M Coding:
Break These 5 Bad Hospital Coding Habits
Ring in the New Year with an improved understanding of subsequent hospital care coding. ... Read more
Break These 5 Bad Hospital Coding Habits
Ring in the New Year with an improved understanding of subsequent hospital care coding. ... Read more
Part B Payment:
Congress Offers 3-Month Reprieve on Conversion Factor Cuts
Plus: Government moves toward possible SGR repeal. If you weren’t looking forwar... Read more
Congress Offers 3-Month Reprieve on Conversion Factor Cuts
Plus: Government moves toward possible SGR repeal. If you weren’t looking forwar... Read more
Reader Question:
Figure Out How to Code Splinting/Strapping Services
Question: What are the keys to deciding when to report splinting and when to report stra... Read more
Figure Out How to Code Splinting/Strapping Services
Question: What are the keys to deciding when to report splinting and when to report stra... Read more
Reader Question:
Define Date for Global Package
Question: The CPT® surgery guidelines state that the surgical package includes &ldqu... Read more
Define Date for Global Package
Question: The CPT® surgery guidelines state that the surgical package includes &ldqu... Read more
You Be the Coder:
Claw Toe Surgery With Tendon Transfer
Question: How should I code for a claw toe surgery with a tendon transfer? Is it th... Read more
Claw Toe Surgery With Tendon Transfer
Question: How should I code for a claw toe surgery with a tendon transfer? Is it th... Read more
ICD-9 Coding:
Avoid Tough Callus and Corn Coding
Keep the jargon straight for common foot conditions. For podiatrists treating the skin... Read more
Avoid Tough Callus and Corn Coding
Keep the jargon straight for common foot conditions. For podiatrists treating the skin... Read more
CPT® 2014:
99446-99449: New E/M Codes Capture Doc Discussions
Make sure to include a written report. Who knows if Medicare will pay, but you should ... Read more
99446-99449: New E/M Codes Capture Doc Discussions
Make sure to include a written report. Who knows if Medicare will pay, but you should ... Read more
E/M:
Navigate the New-Versus-Established-Patient Maze With Expert Tips
Different locations, same physician? Use established patient codes. When reporti... Read more
Navigate the New-Versus-Established-Patient Maze With Expert Tips
Different locations, same physician? Use established patient codes. When reporti... Read more
EHR Mythbuster:
3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are... Read more
3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are... Read more
Reader Question:
Test Your ICD-10 Coding in March
Question: I have heard that there will be a test period for using ICD-10 codes on claims... Read more
Test Your ICD-10 Coding in March
Question: I have heard that there will be a test period for using ICD-10 codes on claims... Read more
Reader Question:
Know How to Email Without Violating HIPAA
Question: I sometimes e-mail patient records to consultants for help on how to bill. How... Read more
Know How to Email Without Violating HIPAA
Question: I sometimes e-mail patient records to consultants for help on how to bill. How... Read more
Reader Question:
Opt for First-Initial, Last-Name Privacy Protocol
Question: What guidelines should our group follow to protect the privacy of patient info... Read more
Opt for First-Initial, Last-Name Privacy Protocol
Question: What guidelines should our group follow to protect the privacy of patient info... Read more
You Be the Coder:
Diabetes Patient, Post-Amputation
Question: A patient visited our clinic for a checkup for some ulcers on her right ankle.... Read more
Diabetes Patient, Post-Amputation
Question: A patient visited our clinic for a checkup for some ulcers on her right ankle.... Read more