E/M: Avoid Getting Caught in These 3 Common E/M Traps   (August 2011)

Incident to, critical care must meet certain criteria.
As a podiatry coder, you’re accustomed to reporting office/outpatient E/M codes (99201-99215) on an everyday basis. Some Part B providers are falling prey to several common E/M myths, however, so read on to be sure you know the facts.
Myth 1: Report Supervising Physician for “Incident to”
Some coders believe that when you report 99211 “incident to” a physician, you should bill under the name of the physician on record [...]

Billing: Don’t Overlook Waiver Opportunities — 3 Steps Ensure Compliance and Patient Payment   (August 2011)

Hint: Documented financial hardship is your key.
You’ve heard the mantra over and over – never waive a copay or deductible and don’t offer discounts! In many cases, that mantra is correct.
There are times, however, when you can offer patients with documented financial hardship a discount or waiver. Let our experts tell you the three steps to properly waiving patient fees based on financial hardship.
1. Understand the Exception to the Rule
Routinely waiving deductibles and copayments can violate [...]

ABN: You Must Use New Form by Nov. 1, CMS Says   (August 2011)

Don’t expect major changes, but you are required to switch.
You should be used to the combined Advance Beneficiary Notification (ABN)/ Notice of Exclusion of Medicare Benefits (NEMB) form implemented last year. But did you know it’s time again to upgrade to a newer version? The latest version of the ABN – form CMS-R-193, with the release date of March 20, 2011 – is now available at www.cms.gov/BNI by clicking the “revised ABN” link, said CMS’s Donna Williamson [...]

You Be the Coder: Freiberg’s Disease   (August 2011)

Question: Which diagnosis code should I use for Freiberg’s disease in both feet (second and fourth metatarsal heads of the right and left foot, respectively)? It is not normally found in both feet. South Carolina Subscriber
Answer: The code for his condition, Freiberg’s disease, is 732.5 (Osteochondropathies; juvenile osteochondrosis of foot).
You do not need to specify where this rare disease of the metatarsals of the feet is occurring; you only append location modifiers to CPT® [...]

Reader Question: 28296 or 28306 for Crescentic Osteotomy   (August 2011)

Question: How should I code a crescent shelf osteotomy for a hallux valgus case?
New York Subscriber
Answer: You have two coding options to choose from when reporting this service.
One option is to use 28296 (Correction, hallux valgus [bunion], with or without sesamoidectomy; with metatarsal osteotomy [e.g., Mitchell, Chevron, or concentric type procedures).
The second option is to select 28306 (Osteotomy, with or without lengthening, shortening, or angular correction, metatarsal; first metatarsal).
In a crescentic osteotomy procedure, the proximal [...]

Reader Question: Don’t Sweat Hyperhidrosis Diagnosis   (August 2011)

Question: What is the appropriate diagnosis code for hyperhidrosis?
Wisconsin Subscriber
Answer: Begin by checking 705.21 (Primary focal hyperhidrosis) and 705.22 (Secondary focal hyperhidrosis). ICD-9’s “Symptoms, Signs and Ill-defined Conditions” section also includes 780.8 (Generalized hyperhidrosis).
A variety of underlying conditions can cause secondary hyperhidrosis, including medication side effects and some rare dermatologic syndromes. Researchers are also studying the connection between hyperhidrosis and social anxiety disorders and other psychiatric conditions. Get more details about the patient’s condition from [...]

Reader Question: 90058 May Help You Collect Extra for Emergency Walk-Ins   (August 2011)

Question: We recently hired a new podiatrist who is questioning whether we can bill any extra codes for a walk-in established patient. He told us that his previous practice was able to collect for the office visit code and 99058. Is this accurate?
West Virginia Subscriber
Answer: Many practices do collect for 99058 (Service[s] provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service) when billed with office [...]

Reader Question: Know When to Bill Secondary Payer   (August 2011)

Question: We have many patients with secondary insurance, some of which have deductibles on the secondary. In these cases, should we write off the amount of the deductible because it’s secondary, or do we bill the patient?
Virginia Subscriber
Answer: Most practices do bill the secondary insurance on behalf of patients, but if the patient has a deductible on the secondary insurance, you can and should bill the patient that amount.
You can find out about secondary [...]

Reader Question: Get Payer Advice in Writing Regarding Employee Copays   (August 2011)

Question: My physicians are looking at giving employees a courtesy for their co-pays but want something in writing stating it’s okay. Is this practice acceptable?
Kansas Subscriber
Answer: The only thing you can get in writing that will hold up is something from the payer(s) that the employees have insurance coverage with and that your providers purchase your employee insurance from.
Bottom line: If that payer says it is okay – in writing – your doctors can waive the co-pays. [...]

CCI 17.2 Update: 10021-10022 Becomes Bundled Into 9 New Foot Procedures   (July 2011)

Use a modifier to report FNA separately when appropriate.
CCI version 17.2, which takes effect July 1, offers 2,367 new edit pairs and deletes 336 bundles, according to an analysis by Frank Cohen, MPA, MBB, principal and senior analyst with The Frank Cohen Group, LLC. The majority of edits impact the codes from the musculoskeletal code range (20000-29999), but bundles did occur to codes throughout the CPT® manual.
For instance: Although the CCI previously appeared to do [...]