“I saw a patient at the wound care clinic, and he presented with an abscess that required urgent incision and drainage. I sent him directly to the emergency room for admission, work-up for sepsis and later that evening performed an incision of the 3rd intermetatarsal space, bone biopsy of the third metatarsal and application of a wound vac. I followed him while he was admitted. I am not sure how to code the initial visit in the wound care clinic. I am not sure about modifiers for the “decision for surgery.” Can I bill for the subsequent daily rounding and changes of the VAC while he was admitted? Could you please advise the proper billing?”
The MIPS automatic EUC policy doesn’t apply to MIPS eligible clinicians participating in MIPS as a group, subgroup, virtual group, or Alternative Payment Model (APM) Entity. However, groups, virtual groups, and APM Entities can request reweighting through the EUC Exception application. Subgroups will inherit any reweighting approved for their affiliated group; they can’t request reweighting independent of their affiliated group’s status.
“I saw an established patient who returned to the office for Routine Foot Care. The patient also had a new complaint of heel pain. I obtained X-rays of the foot and gave a steroid injection into the heel. Can I bill for the Routine Foot Care and those treatments as well?”