“Here’s the scenario: patient has a chronic ulcer left foot that comes in for regular debridements/wound care. Two weeks ago he has a full thickness ulcer and osteomyelitis at the 2nd toe right foot and I performed a partial amputation of the toe in the office. He comes in for postop check five days later and everything is fine. At his 2nd postoperative visit, I notice a new punctate ulcer plantar 2nd toe with exposed bone and progressing osteomyelitis. I did a prep and debrided the bone at this visit (Yes, authorization was submitted for a more proximal amputation at a future appointment.) I also debrided the wound on his left foot. The question I have is with a multiple modifier order/rule for the debridedment of the ulcer left foot. I billed the visit out as follows:
CPT 11044-78,T6
CPT 11042-59,79,LT
Should the order of the modifiers with the CPT 11042 be -59,79 or -79,59 (or does this matter?) I have seen coding recommendations that say that the 1st modifier should be the “pricing” modifier and the 2nd modifier should be the “procedure” modifier but I am not sure of this.”
The Right of Access Rule gives patients and their representatives the right to access, inspect and obtain a copy of their own health information. When a provider receives a request for access to their medical records, they must provide the requested information within 30 days (Some states require a faster response 30 days is the HIPAA requirement).
This means that the CMS 1135 Waivers have been extended through April 20. Some of the waivers may impact your practice while most of the waivers are related to hospital care.
Last week we published an article that Prestera Health was breached due to a vulnerability in their email system. This Week Jefferson Healthcare in Port Townsend, WA experienced a breach related to their email system.
“I am trying to get a handle on the 2021 E/M changes. The question I have is about the defining pathology/diagnosis as “acute” versus “chronic.” This is critical in the portion of the medical decision making. What do the guidelines tell us about these definitions?”
