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Medical Coding

Coding Pearls - ABNs and CPT 11750
Coding

Coding Pearls - ABNs and CPT 11750

by Michael Warshaw, DPM, CPC

“I have a question concerning Medicare’s rules when billing for repeat CPT 11750. What is the recommendation for billing these for a regrowth following a previous CPT 11750? In another scenario, on the same subject, what if the procedure needs to be performed on a nail border that is adjacent to one that was already billed? Can and should we use an ABN and upon denial, bill the patient?”
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Coding Pearls - The Basics of Fracture Treatment Coding
Coding

Coding Pearls - The Basics of Fracture Treatment Coding

by Michael Warshaw, DPM, CPC

“How are fracture care codes used? If a patient comes into the clinic with a fracture that you plan on eventually operating on, can you bill a closed fracture care code and then bill the surgical code when the open reduction and internal fixation is performed in the operating room?”
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Coding Pearls
Coding

Coding Pearls

by Michael Warshaw, DPM, CPC

“So, to be clear you can never use L3000KX for a diabetic with neuropathy and diabetic ulcers even if secondary will pay.”
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ROUTINE  FOOT CARE - Chronic Kidney Disease
Coding

ROUTINE FOOT CARE - Chronic Kidney Disease

by Michael Warshaw, DPM, CPC

“Any thoughts on whether ICD-10-CM codes N18.1-N18.6 (chronic kidney disease) are “asterisk” covered diagnoses’ for nail and callus codes? I practice in Illinois. If so, are the date of last service and a Q modifier all that are needed?“
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Billing For Local Anesthetics With Procedures
Coding

Billing For Local Anesthetics With Procedures

by Michael Warshaw, DPM, CPC

“I’m in an ongoing debate with my biller. I have always been under the impression that when billing for infected, ingrown nails that local anesthetics were considered part of the procedure. My biller thinks I can charge for them. What is correct?"
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Nail Biopsy
Coding

Nail Biopsy

by Michael Warshaw, DPM, CPC

“I have a patient with a longitudinal striation of her toenail, and we are going to biopsy the nail bed. What ICD-10 do code would you consider for the diagnosis for the biopsy? What is the CPT procedure code for the nail matrix?”
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Post Operative Wound Care
Coding

Post Operative Wound Care

by Michael Warshaw, DPM, CPC

“I was consulted on a patient in hospital with a large 5th metatarsophalangeal joint ulceration. There was osteomyelitis of the proximal phalanx and metatarsal head. I performed the resection and subsequently performed a delayed closure several days later. The closure left an area open due to soft tissue deficit. This necessitated post operative wound care. I initially billed CPT 28810 and then subsequently CPT 13160. I billed CPT 11042 weekly post operatively, until the wound healed. The private insurance states that all the CPT 11042 billings are considered part of the global. Is there a modifier for submitting related charges for necessary services?”
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Routine Foot Care: Annual E/M Service
Coding

Routine Foot Care: Annual E/M Service

by Michael Warshaw, DPM, CPC

“My documentation for qualified, routine foot care is similar for most patients as little changes in 3 months. But, yes, I do look for changes and make the note reflect such. And I try to make sure notes are not exact copies of previous notes. My notes have plenty of bullet points for an E/M code on each visit. I am primarily charging procedure codes only (CPT 11056, CPT 11721, etc). Can I still bill at least one E/M code per year even when there are no substantive changes as I continually monitor vascular, neurologic and dermal changes each visit? Must I have a new or different diagnosis to bill an E/M code?”
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Rules For Retained Hardware
Coding

Rules For Retained Hardware

by Michael Warshaw, DPM, CPC

“I know things have changed a little for removal of retained hardware and I am seeking clarification for a scenario. A patient has previously had an Austin Akin bunionectomy. It healed uneventfully. Years later, she has developed pain at the retained screw in the metatarsal. There is a k-wire noted in the proximal phalanx. X-rays showed complete healing at the osteotomies. The patient would like to have both implants removed despite only one of them hurting today. How would the changes in CPT coding apply to this situation? Thank you for the help.”
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Using L3000kx
Coding

Using L3000kx

by Michael Warshaw, DPM, CPC

“So, to be clear you can never use L3000kx for a diabetic with neuropathy and diabetic ulcers even if secondary will pay.”
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