Podiatry Coding & Billing Alert

Question: A patient presented in the office some paperwork for the podiatrist to fill out as part of an evaluation to determine disability benefits. As Medicare no longer allows the billing of consult codes, I am assuming that Medicaid has followed suit. Is there a specific CPT for performing a Department of Social and Health Services (DSHS) evaluation?

Maine Subscriber

Answer: You would have to code the procedure with an E/M even if consult codes were available. The specific E/M would depend on whether the patient is new or established. Some physicians, in fact, would charge cash to fill out this type of paperwork.

New vs. Consultation: Determining whether the patient is new or established is the first step in the E/M coding process. New patients have not been seen by the treating podiatrist or another podiatrist in the same practice in the past three years. Established patients have been seen by the treating podiatrist or another podiatrist in the same practice within the last three years. Clarification: Medicaid may have stated they will not accept consult codes, but that is directly for hospital consults.