Coding

Peripheral Neuropathy is the most common factor leading to amputation in people with diabetes. In diabetes, peripheral neuropathy is an anatomically diffuse process primarily affecting sensory and autonomic fibers.

Routine Foot Care, which includes trimming or debridement of the asymptomatic, dystrophic, mycotic, or normal toenails are covered by Medicare only when the patient has one of the Medicare-specified systemic diseases with clinically significant peripheral complications placing the patient “At Risk” for infection and/or injury if a non-professional attempts to trim or debride the nail.

“If orthotics are not covered by Medicare, if the KX modifier is appended to L3000-RT and L3000-LT, I am getting paid. Is it wrong to use the KX modifier to get paid for orthotics?”

What is the difference between an asterisk and a non-asterisk systemic disease with respect to “At Risk,” Routine Foot Care?

Updates Regarding CPT codes 11730 and 11750

What are the definitions of Modifiers 58, 76, 77, 78, 79 and how do they differ?

What is one to do when a patient wants a claim to be resubmitted after her deductible is met when the claim was originally submitted prior to the deductible being met?

What are the guidelines for selecting the level of E/M service based upon Medical Decision Making (MDM)?

CPT® has provided numerous definitions to clarify terms in the current guidelines, such as “chronic illness with exacerbation, progression or side effects of treatment,” and “drug therapy requiring intensive monitoring for toxicity.”

What are the guidelines/rules for billing an E/M service based upon total time?