I had the opportunity to read an article from the American Bar Association about the use of Emojis as evidence in courts. The article brought up a number of very interesting potential issues related to Emojis.
“I read the Medicare DME requirements for diabetic shoes and inserts. I am still confused and am seeking clarity. I know for diabetic shoes, it requires a MD/DO to certify that patient has diabetes with neuropathy and thus, qualifies for diabetic shoes and 3 custom insoles. It is my understanding that Medicare only covers orthotics if the patient is diabetic and as stated above, is certified to have diabetes with neuropathy. I have seen other physicians use the KX modifier to get orthotics incorrectly paid. My question is: If I just want to dispense the custom molded diabetic insoles (three pairs of orthotics/diabetic insoles as allowed by Medicare — and not the shoes), are there separate rules or are they the same rules? Is it legal to do a cash pay for diabetic/soft custom insoles? Any other tips you have found useful in your practice? Have you in your practice just dispensed the insoles and not the shoes?”
“I saw a patient on March 20, 2020 with a new, mildly displaced 3rd metatarsal fracture (S92.332A). I have been following him since then and have billed Anthem Blue Cross with ICD10 S92.331D and have gotten reimbursed. The last visit I had with the patient was August 17, 2020 and billed Anthem Blue Cross for S92.332S. The claim was denied as Missing/incomplete/invalid principal diagnosis. Isn’t S92.332S a valid primary diagnosis code?”