“I’m trying to determine the coverage of diabetic shoes for a patient who has had one foot/leg amputated. Somewhere in my brain I seem to remember that Medicare will cover a pair of shoes so the amputee can wear the shoe on his prosthetic. Does this also apply to heat moldable inserts? Can we dispense them for the shoe that will be used on the prosthetic leg? I would appreciate any thoughts on this situation. I have read the LCD and associated article but can’t seem to fully understand how this works.”
Alameda Health Systems in California recently reported a patient data breach that impacted the information of approximately 90,000 patients. This breach involved unauthorized access to the email accounts of email accounts. This enabled the hackers to use the email accounts to gain access to the patient information.
“I just received a letter from Cigna insurance. As of August 13, 2022, they will require the submission of office notes with claims submitted with Evaluation and Management/E and M codes (ie. 99212, CPT 99213, CPT 99214) appended by modifier -25 when a minor procedure is also billed the same day by the same physician. The E/M will be denied if documentation is not received. The claim can be sent electronically with attachment indicator and notes should be faxed. Is this happening with other insurance companies? The amount of paperwork for a small office is crazy and along with continued decreasing reimbursements, higher prices for supplies, shortages, etc. The insurance companies are making greater profits than ever. The insurance premiums have increased and out-of-pocket patient billing has become more significant. The system is not right. What can we do? How do we fight back? Please don’t say take cash rather than insurance, it’s not practical in many circumstances. Any thoughts?”
