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Medical Billing

Coding

Retrocalcaneal Surgical Treatment

by Dr. Michael Warshaw, DPM, CPC

“Can anyone please explain the CPT codes for retrocalcaneal surgical treatment? Specifically, the combination of codes that can billed for this pathology. 1. Secondary repair of Achilles tendon 2. Resection of a Haglunds deformity 3. Resection of posterior calcaneal spur.”
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Coding

Medicare Guidelines for Palliative Care

by Dr. Michael Warshaw, DPM, CPC

“I am looking for a relatively concise explanation regarding Medicare’s policy on palliative care and coverage for diabetics and non-diabetics. As of late, fewer and fewer charges for nail debridement and keratosis debridement are being reimbursed. I have tried to search through Medicare’s guidelines but there is not enough time in a year to sift through the documentation. Is there such a thing as a concise explanation for Medicare’s guidelines for palliative care and CPT codes with ICD-10 codes?”
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Coding

Certifying DM Shoes

by Dr. Michael Warshaw, DPM, CPC

“Our office has decided to take the leap and do diabetic shoes for patients who see a Nurse Practitioner or a Physician’s Assistant. Has anyone had any luck with this? We are noticing that we are not hearing much about this since earlier this year.”
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Coding

Debridement with Skin Substitutes

by Dr. Michael Warshaw, DPM, CPC

“Can one appropriately bill a debridement code, such as CPT 11042, each time when applying a skin substitute if indicated in a hospital, outpatient wound care clinic?”
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Coding

Removal of Implant and Conversion to Fusion

by Dr. Michael Warshaw, DPM, CPC

“I performed a removal of a failed 1st metatarsophalangeal implant and, at the same setting, an arthrodesis. Should I bill for both the removal of the implant and subsequent fusion?”
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Coding

Reading X-rays from an Outside Source

by Dr. Michael Warshaw, DPM, CPC

“We have a disagreement among our group regarding radiology billing. If a new patient presents with x-rays, MRI, etc., from an outside source, without a report (or with an inadequate report), can the podiatrist bill for the professional component of reading the imaging studies provided?”
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Coding

Emergency Service

by Dr. Michael Warshaw, DPM, CPC

“I had a patient call me worried about a possible diabetic foot infection. The patient has a history of below the knee amputation at the other limb and was panicked about the potential loss of limb. I worked them into the schedule that day and I am thinking about coding CPT 99058 in addition to the E/M code. Can I get paid for CPT 99058 and does it matter if the potential “infection” turned out to be not infected?”
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Coding

Multiple Fractures of the Toe

by Dr. Michael Warshaw, DPM, CPC

“My patient suffered blunt trauma to his right hallux and suffered non-displaced fractures of the distal and proximal phalanx. We are going to treat this injury conservatively. Would it be appropriate to bill CPT 28490 two times to represent the treatment of both phalanx?”
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Coding

Stable, Chronic vs. Chronic With Exacerbation/Progression

by Dr. Michael Warshaw, DPM, CPC

“As a general question, I am wondering if a physician documents that the patient has had symptoms for longer than a year and has failed conservative/other treatment, can this problem be considered as “chronic with exacerbation/progression”? I am referring to the verbiage in the CPT book (page 13, under Stable, chronic illness) regarding the expected duration of at least 1 year and am wondering if it is applicable in this scenario. Also, I know that a diagnosis of osteoarthritis is inherently considered “chronic”, but I am wondering if there are other diagnoses that can be considered ‘chronic’, as well?”
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Coding

Fracture Care Global

by Dr. Michael Warshaw, DPM, CPC

“What is the date that fracture care begins? Is it the date of the injury or is it the date of service when the doctor makes the decision for closed management of a fracture?”
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