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Coding
Orthotic Billing for an E/M Service on the Same Date of Service
A claim for orthotics, L3000 right and L3000 left is being sent to Care-First Blue Cross Blue Shield Washington DC. Question: is Place of Service still #12 (Home)?
I ask because a claim was recently denied for POS 12 for orthotics (too early to know if changing it to Place of Service 11 for Office was successful.
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FDA Recalls
Coding
Wound Care Billing Debridement Codes
“I do some part time work in a wound care center. I frequently use CPT 97597 for coding. My biller is telling me not to bill CPT 97597 because it reimburses around $25 or less in a wound care center. However, the facility likes and even encourages me to use CPT 97597. If I do a selective debridement, can I bill CPT 99213 or CPT 99212 instead of CPT 97597? I know that I should not bill CPT 99213-Modifier 25 if there isn’t a separate complaint. Am I required to bill 97597? Is this a scenario that I should be considering CPT 11042?”
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HIPAA
February HIPAA Deadline
To provide a comprehensive evaluation for a medical professional, we need to move beyond "cybersecurity news" and address how these events threaten the Continuity of Care, Patient Safety, and Legal Compliance.
The 2025-2026 landscape demonstrates that data breaches are no longer just administrative headaches; they are clinical emergencies.
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FDA Recalls
Coding
Hospital Consultations
“After watching some E/M presentations, it was suggested that hospital consultations should be billed with CPT 99252-CPT 99255. When we billed these codes, our EMR system and our clearing house rejected the codes. They are saying effective 1/1/2010, CMS has announced that they will reject codes. Are we billing the right codes?”
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