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Coding
Subsequent Debridements
“I have been getting insurance denials for subsequent billing of CPT code 11042 after one has been previously performed. Regardless of what level of tissue is debrided, my biller is saying I can only bill CPT code 11042 every 60 days. The biller is telling me that if I debride any level of tissue within those 60 days, I should bill CPT code 97597 until 60 days have passed. Then after 60 days, I can bill CPT code 11042. This does not seem appropriate. Should we appeal?”
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Coding
Telehealth Billing
“We have had an influx of phone calls that are burdening our clinical hours. We have been flooded with questions that pertain to patient care, clarification of orders and home care instructions. Is there a way to bill for these calls? Each call can take 20-45 minutes for our medical assistants to complete. And we are trying to manage a full clinic at the same time.”
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Coding
Billing For Intraoperative Fluoroscopy
Can I bill for using intraoperative fluoroscopy (C-arm) to assist in hardware placement before, during and after the procedure? The images are all taken while in the operating room. If so, do I need a modifier for the code? Can I use the same CPT for the surgery with the code for the intraoperative x-ray or does it require a different CPT code? Thank you!
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MIPS
Crunch Time for MIPS
The year is 75% complete so now is CRUNCH time for many providers participating in the MIPS program for 2024. Many of the measures you report on are ‘Once Per Reporting Period’. That means you only need to meet the measure on one visit for each patient during 2024. Even if you failed to meet measures prior to today, by making sure you meet the quality measure the next time the patient walks in the door, you get credit for that measure.
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FDA Recalls
HIPAA
The Increased Risk of Ransomware
Ransomware attacks targeting industrial organizations has reached new heights and no organization is immune.
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