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Coding

Diagnoses Codes for Structural Foot Conditions
Coding

Diagnoses Codes for Structural Foot Conditions

by Michael Warshaw, DPM, CPC

What are the relevant ICD-10 codes that are accurate to describe conditions like “excessive pronation”, varus/valgus, or pes cavus issues?
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Coding Documentation Guidelines for Level 4 using Medical Decision Making & E/M Service for Treatment of Paronychia
Coding

Coding Documentation Guidelines for Level 4 using Medical Decision Making & E/M Service for Treatment of Paronychia

by Michael Warshaw, DPM, CPC

Part I: What are the coding documentation guidelines for Level 4, specifically 99204 and 99214 using Medical Decision Making? Part 2: What level of E/M service does the treatment of a paronychia qualify for?
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Definition of Chronic
Coding

Definition of Chronic

by Michael Warshaw, DPM, CPC

When selecting the level of E/M service based upon medical decision-making, the best source of information is the Level of Medical Decision-Making Table. The table includes the four levels of medical decision making (ie, straightforward, low, moderate, high) and the three elements of medical decision making (ie, “number and complexity of problems addressed,” “amount and/or complexity of data reviewed and analyzed,” “and risk of complications and/or morbidity or mortality of patient management”). To qualify for a particular level of medical decision making, two of the three elements for that level of medical decision making must be met or exceeded. It is under “Number and/or Complexity of Problems Addressed” that the issue of acute versus chronic is addressed. Acute versus chronic is not based upon a “time frame.”
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Recurring Punctate Hyperkeratotic Lesion
Coding

Recurring Punctate Hyperkeratotic Lesion

by Michael Warshaw, DPM, CPC

“I have a patient who returns to the office for regular treatment of a hyperkeratotic lesion. Our documentation states “a hyperkeratotic lesion with a punctate keratin core with obliteration of skin tension lines to the sub 5th metatarsal head.” The plan is documented as “Cold spray to the lesion for anesthesia. The lesion was then circumscribed with #15 blade. The keratotic core then excised down to the level of the basement membrane. Bleeding was appreciated, then controlled with compression. No biopsy was performed.” Can I ever bill this as a CPT 11305? with a D23.7? If so, can this be done every 10 weeks?”
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Recurrent IPK and Treatment
Coding

Recurrent IPK and Treatment

by Michael Warshaw, DPM, CPC

“I have a patient who returns to the office for recurrent six intractable porokeratosis. I have treated this situation for the patient about three months previously and I billed CPT code 17110 after treating it with an application of Cantharone. Can I bill CPT 17110 at this second visit?”
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CPT 20550
Coding

CPT 20550

by Michael Warshaw, DPM, CPC

“We performed a heel injection on the right foot for a patient with plantar fasciitis. I used CPT 20550 -RT. UnitedHealthcare denied the claim stating we could not prove we injected a substance on a CPT code that requires it. I discussed this with the “MARS” auditor and that was her comment. Any suggestions on why this was denied and how to correct it?”
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Consultation E/M Coding
Coding

Consultation E/M Coding

by Michael Warshaw, DPM, CPC

If a patient that has Traditional Medicare and a secondary coinsurance, when, if ever, is it appropriate or is it payable to bill for a consultation code such as CPT 99243 or CPT 99244?
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CPT Codes 11730 and 11750
Coding

CPT Codes 11730 and 11750

by Michael Warshaw, DPM, CPC

Can CPT codes 11730 and 11750 be billed together on the same toe as part of the same procedure?
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Medicare Patient with Secondary Insurance
Coding

Medicare Patient with Secondary Insurance

by Michael Warshaw, DPM, CPC

If a Medicare patient has a secondary, supplemental insurance that our practice does not participate with, how should this be handled?
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Fractures, Dislocations, Casts, and Splints
Coding

Fractures, Dislocations, Casts, and Splints

by Michael Warshaw, DPM, CPC

Fractures, Dislocations, Casts, and Splints
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