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Coding
Post Operative Wound Care
“I was consulted on a patient in hospital with a large 5th metatarsophalangeal joint ulceration. There was osteomyelitis of the proximal phalanx and metatarsal head. I performed the resection and subsequently performed a delayed closure several days later. The closure left an area open due to soft tissue deficit. This necessitated post operative wound care. I initially billed CPT 28810 and then subsequently CPT 13160. I billed CPT 11042 weekly post operatively, until the wound healed. The private insurance states that all the CPT 11042 billings are considered part of the global. Is there a modifier for submitting related charges for necessary services?”
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FDA Recalls
Coding
Routine Foot Care: Annual E/M Service
“My documentation for qualified, routine foot care is similar for most patients as little changes in 3 months. But, yes, I do look for changes and make the note reflect such. And I try to make sure notes are not exact copies of previous notes. My notes have plenty of bullet points for an E/M code on each visit. I am primarily charging procedure codes only (CPT 11056, CPT 11721, etc). Can I still bill at least one E/M code per year even when there are no substantive changes as I continually monitor vascular, neurologic and dermal changes each visit? Must I have a new or different diagnosis to bill an E/M code?”
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FDA Recalls
FDA Recalls
Practice Management
Marketing and Referral Relationship Compliance - Being in the Know
Often, health care providers do not even realize how marketing arrangements can violate the Anti-Kickback Statute and other state marketing/brokering laws. It is completely natural for health care providers to market; they need to get business and establish referral relationships with other practitioners. With this, health care professionals often rely on marketing companies, MSOs (management services organization), pharmaceutical companies, or referral entities that represent that an agreement is compliant with such statutes a provider will not have checked by an attorney.
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