“Can anyone offer advice or input for a telemedicine visit? The telemedicine visit was performed to update a history and physical prior to surgery AND it is performed by a medical assistant.”
“I have a patient who honestly only has three mycotic/dystrophic toenails. This elderly gentleman, with Medicare, returns to the office every 90 days for routine foot care (RFC). According to Medicare guidelines, he does qualify for RFC with his physical examine findings. My question is can I bill CPT 11720 for the debridement of the three dystrophic nails and then CPT 11719 for the trimming of the other seven non-dystrophic toenails?”
“How would you code this? I’m stumped.
Operation 1. Attention was directed to the medial aspect of left great toe where an incision was made overlying the interphalangeal joint. The incision measured about 3-4 cm in length, the incision was deepened via sharp and blunt dissection, careful attention paid to all neurovascular structures appropriately retracted as necessary. The incision was carried down to bone, the soft tissue was freed from the medial side of the bone at the IPJ. The long flexor tendon was reflected plantarly. The accessory bone was found on the left and seemed to be adherent to the phalanx. It was removed and sent to pathology. The wound was flushed. C-arm radiograph taken pre and post to be sure that the bone had been removed. It was. The flexor tendon was reapproximated and maintained using 2-0 Vicryl, skin closure with 2-0 Vicryl. 4-0 Prolene.
Operation 2. Same, right foot
Operation 3. Attention was directed to the ulcer of the left great toe, 2 converging semielliptical incisions made surrounding the ulcer, excised and sent to pathology. There was necrotic tissue and debris within it. This was sent as well. The wound was flushed and closure performed using 2-0 Vicryl, 4-0 Prolene.
Operation 4. Same, right great toe
The doctor coded it as follows: CPT 28315-50, CPT 11422-TA, CPT 11422-T5.”
The most recent breach was reported by QRS Healthcare Solutions who has the EHR product Paradigm. What does this mean and what can you learn to protect your practice?
