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FDA Recalls
Coding
Wound Care Coding - Debridement in the Postop Period
“The patient initially had a gastroc recession at the right lower extremity. Our surgeon performed a debridement procedure for the right foot ulceration. It was performed in the clinic, and we planned to code it as CPT 11042. However, the patient is in the 90-day post op period from initial surgery that was performed 4 weeks ago. Is a modifier necessary to submit for payment? Is it 79?”
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MIPS
2026 is here – Are you ready for MIPS?
2026 is here – Are you ready for MIPS? This year brings a lot of changes for Podiatry in MIPS including: A Podiatry MIPS Value Pathway.
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Coding
Qlarant Review UPIC Audit
“We received a request for medical records from Qlarant, who apparently is contracted with Medicare to review records for medical (and, of course, payment) necessity. In this case, they’ve asked for chart notes for ten different patients, one date of service for each patient. We’ve never been subjected to this type of review previously and want to do everything possible to make sure that we submit the appropriate and sufficient records and that we submit them in the appropriate manner. Obviously, we’re also concerned that this inquiry is a fishing expedition that could trigger some larger audit. Is there any advice that you can provide that might help us through this process? In our review of the records that were requested we did notice a few minor billing errors, but we believe that the records substantiate payment for all treatment that was performed.”
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HIPAA
Email Security
Maintaining good email security is an important factor in keeping your network secure and your patient information safe. Statistics show that 75-90% of cyberattacks start with a phishing email, making it the top delivery method for malware and/or ransomware. Email Security needs to be addressed whether or not emails are used to send patient information. Any time anyone, an employee or a patient, sends or receives emails on your network, that is an access point to your network. In order to protect your network, we need to determine what security protocols are in place to ensure nothing malicious is able to piggy-back on the email connections.
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FDA Recalls