News

FDA Recalls May 12 - 18

Beginning in 2022, if you order Medicare Part B advanced diagnostic imaging services, you must consult appropriate use criteria (AUC) through a qualified Clinical Decision Support Mechanism (CDSM). You must also provide the information to furnishing professionals and facilities, because they must report AUC consultation information on their Medicare claims. When we use “you”, we are referring to physicians, other practitioners, and facilities ordering advanced diagnostic imaging services and/or furnishing Part B advanced diagnostic imaging services to Medicare beneficiaries and billing Medicare Administrative Contractors (MACs).

On April 27th, an EHR system company sent an email to hosted customers detailing a ransomware incident. According to the email, "A sophisticated criminal organization carried out a ransomware attack on some of the hosting vendor’s systems, disaster recovery site, and backups." As a result of this outage, many customers lost access to their EHR system.

The CDC has recently stated that individuals who have been vaccinated do not need to wear masks. As a result, many states have lifted mask restrictions. This begs the question of what to do if your state has lifted mask restrictions and somebody walks into your office without a mask?

FDA Recalls May 6 - 11

“I have several healthy Medicare patients that have painful calluses. These patients come to my office, sometimes monthly complaining of painful callouses. I understand that Medicare does not cover the routine trimming of calluses in healthy patients. However, I have been billing CPT 99212-13 with the diagnosis codes of L84 (corns and callous), M77.4X (metatarsalgia). The documented management plan for L84 is discussion of moisturizing the feet, not waking barefoot, etc. and then I debride the callus. The documented management plan for metatarsalgia is discussion of metatarsalgia and surgical options, and then I place felt padding in the shoe, or modify the shoe to take pressure off the callus. My patients rarely follow my advice for moisturizing and not going barefoot; so ultimately, the calluses come back. Is this appropriate billing? The treatment I provide is instrumental in preventing a wound or ulceration from occurring (which I also document). Also, it relieves the patient of pain. Is it appropriate to bill an E/M code in lieu of a procedure code if the procedure is not covered?”