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Practice Management
It’s Better to be Decisive than Right
One of my biggest pet peeves is indecisiveness and as I get older, I find myself going to great lengths to avoid individuals who simply cannot make up their mind. In my opinion, going out for dinner should be an enjoyable experience, not a logistical nightmare of reading dozens of Yelp reviews, and changing your OpenTable reservation so many times that you end up having TUMS for dessert.
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Coding
Routine Foot Care: A Lot of the Same
“I am a young physician and the practice that I am currently at codes almost all routine foot care patients as the following: 1. Tinea ungium B35.1, 2. Peripheral Vascular Disease (PVD) I73.9, 3. Pain in left toe. Documentation is all the same: “All nails are thickened, discolored, and painful with subungual debris” with CPT 11721. Basically, there is no individual nail documentation and all nails are always painful with PVD. This includes younger, disabled patients who present with some thickened nails. I was under the impression that you have to document individual nails and that pain alone is a qualifying diagnosis for nails, if used as the secondary code. My question is: wouldn’t coding only CPT 11721, with pain and PVD to all toes all the time raise red flags?”
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MIPS
MEX5: Hammer Toe Outcome
This is a custom measure for podiatrists that is square in the clinical domain of Podiatry. The Hammer Toe Outcome is the percentage of patients who have lesser toe deformity (hammer and claw tows) causing pain that receive any type of treatment and have significant reduction in pain as a result of that intervention.
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HIPAA
Requesting Pictures of Patients' Feet
"The doctors in our practice request patients to text or email them photos of their various foot conditions and post-op P&As to their personal mobile phones. We know this is not HIPAA compliant. What is a better way to handle these situations?"
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FDA Recalls
MIPS
Measure 001: Hemoglobin A1c
Measure 001 requires documentation of the HbA1c level for diabetic patients between the ages of 18-75. This is an inverse measure – this means YOU DO NOT WANT TO MEET THIS MEASURE. The best score for this measure is a 0.
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