Treatment: Build a Firm Foundation for Plantar Fasciitis Coding   (May 2010)

Thorough documentation of early treatment might help justify 28890.
With heel pain affecting nearly two million Americans and ranging from mild discomfort to debilitating pain, it’s common to see patients quite often who complain of pain where the fascia attaches to the calcaneous, or heel bone. Plantar fasciitis is a condition in which the plantar fascia becomes inflamed and painful and is the most common form of heel pain.
Once your podiatrist diagnoses plantar fasciitis, you’ll report [...]

Wound Care: Refer to This Handy Chart to Make Graft Coding a Cinch   (May 2010)

Careful: Skip over codes for legs and zero in on foot codes.
With the many graft options – including those taken from cadavers, pigs, and newborns – correctly coding a skin graft procedure can leave you guessing. Use this chart to narrow down the grafting field by matching definitions, product names, and treatment applications to CPT codes. Then, you’ll be sure to sail through coding your next graft claim.
Don’t miss: Nothing will get your claim denied faster than [...]

You Be the Coder: Pair G0247 with Initial or Follow Up Exam Code   (May 2010)

Question: My co-worker tells me that you can never report G0247 by itself, is this true?Maine Subscriber
Answer: Yes. G0247 (Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation [LOPS] to include, the local care of superficial wounds [i.e. superficial to muscle and fascia] and at least the following if present: [1] local care of superficial wounds, [2] debridement of corns and calluses, and [...]

Medicare Forms: Beware of Small Transcription Errors That Spell Denial on New 5010   (May 2010)

Omitting “Jr.” or “III” could trigger payment delays.
You’ll want to start double- and triple-checking your claim forms to ensure that the beneficiary’s information is spot-on, or you’ll face scores of denied claims once CMS starts requiring the new HIPAA 5010 forms.
That’s because CMS plans to deny claims filed on HIPAA 5010 forms (which will be the new Medicare universal claim form starting in 2012) on which the beneficiary’s name doesn’t perfectly match how it’s listed [...]

Reader Questions: Modifiers 57/58 Describe Two Fracture Surgeries   (May 2010)

Question: A patient presented to the emergency room and the podiatrist performed a closed reduction and manipulation for a trimalleolar ankle fracture. The closed reduction didn’t work so the DPM returned to surgery to repair the fracture the next day. How should I code both surgeries?
Montana Subscriber
Answer: You’ll need to code for three services: the initial visit and examination the first surgery, and the second surgery.
If the patient was treated in the emergency room, choose [...]

Reader Questions: Generic Code Best for Budin Toe Splint   (May 2010)

Question: What supply code should we report for a Budin toe splint (toe straightener)?
Missouri Subscriber
Answer: HCPCS Level II codes don’t include a code specifically for a Budin toe splint, so one option would be reporting a generic supply code. The closest choice is temporary code Q4051 (Splint supplies, miscellaneous [includes thermoplastics, strapping, fasteners, padding and other supplies]).
Rather than reaching for a non-specific code, however, that payers may not accept for the item, you may [...]

Reader Questions: Recognize a Write-Off in 6 Steps   (May 2010)

Question: My podiatrist never wants to write off any patient bills, but I am afraid he’s expending more effort than it’s worth trying to collect. What’s your best advice for determining a write-off?
New York Subscriber
Answer: Of course, you should resort to a write-off when all other collection methods, including discounts, payment plans, etc., have failed. If you are encountering the following situations, a write-off may be justified:
1. The cost of collecting a balance is more [...]

Reader Questions: Collect Surgical Deductibles Up Front   (May 2010)

Question: We often have patients who don’t pay their deductible after surgery. Is there a recommended way to collect these payments up front?South Dakota SubscriberAnswer: Yes, you may collect a deductible up front. The first step is to confirm the deductible amount with the payer. Insurance verification services now make it possible for practices to find out if a patient has met his deductible yet, or how much remains unpaid. You usually can access updated [...]

Reader Questions: Turn to Initial Hospital Care Codes for Consults   (May 2010)

Question: The podiatrist recently consulted on a new Medicare patient. Medicare no longer accepts the consult codes. What code should I report?
North Dakota Subscriber
Answer: With the no-pay policy on office consultation codes (99241-99245, Office consultation for a new or established patient …) and inpatient consultation codes (99251-99255, Inpatient consultation for a new or established patient …), CMS is poised to allow specialists to bill initial hospital care for their first visit with an inpatient. It [...]

Don’t Leave Money on the Table by Under-Coding Ligament Repair   (April 2010)

If you overlook a secondary repair, you’re missing out on $155.89.
If you see your share of athletes, you probably treat a fair number of sprained ankle ligaments. Pay close attention to the number of incisions and ligaments detailed in the report, and whether the podiatrist also found a fracture, to ensure you arrive at the correct ligament repair code – and the reimbursement you deserve.
Code Separately Per Incision
To avoid missing out on ethical reimbursement for ligament [...]