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FootZine,
Volume 103 |
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We are now just a month away
from the last HIPAA hurdle. April 20, 2005,
is the deadline for
HIPAA Security Rule compliance. The Security
Rule addresses Administrative
Safeguards, Physical Safeguards, and Technical
Safeguards. Now is
the time to review the regulations and be sure
that nothing has been overlooked.
For a second time since the
American Podiatric Medical Association began
announcing its "Best
Walking Cities" awards, Seattle is in the Top
Ten.
Seattle ranked #3 this year,
close behind Arlington, VA, and San Francisco, in
the analysis done by the
APMA's researchers. I would agree that it's
a great
place to walk, especially
when we have had such unusually warm and sunny
weather for this time of
year. More details about the Top Ten cities
and how
the rankings were determined
can be found at this APMA link:
~ Gayle
*_*
"I am a slow walker, but
I never walk backwards." - Abraham
Lincoln
*_*
*_* Letters *_*
From: Robert C. Taylor
re:
Re: 7-E shoes (Volume 54)
My dad wore 7-F shoes and was
able to buy U.S. Navy standard dress shoes
that fit perfectly.
*_* Editor's note:
Since the U.S. Military encompasses a population
with a
varied range of sizes, and
must provide shoes for them all, it seems logical
their suppliers would also be
a good resource. We did find this link for
one
supplier of military and
uniform shoes:
And they start at only
$79.00! ~ Gayle *_*
*_*
*_* *_*
From: Charity O'Connor,
CPC
re:
Medical Billing Course (Volume 102)
Hey Gayle,
I saw a question in last
week's FootZine that I think I can help with.
I
received my coding
certification through the American Academy of
Professional
Coders. (www.aapc.com)
It was an independent study program and cost about
$1000 plus $300 for the
national exam. It was well worth it and I
felt it was
much easier to study at my
own pace. In addition, they have local
chapters
that you can join, a great
opportunity to network with other coders.
As a side note, I wouldn't
recommend the billing programs offered at tech
schools. Those courses
are mostly geared towards billing functions and
insurance claims; they don't
really focus on the coding mechanics.
I hope this helps. Have a
great day!
Charity O'Connor, CPC
WSPMAA Secretary/Membership
Chairman
*_*
*_* *_*
From: Bill McCann, DPM
re:
Medical Billing Course (Volume 102)
Hi Gayle:
Attached is a response to
Nicole from Pennsylvania.
Bill McCann
Nicole:
Consider attending the AAPPM/Codingline/Podiatry
Management coding seminar.
This is a comprehensive
seminar that has all the elements you are looking
for.
Information is below and you
can register on www.aappm.org.
May 13 to 15, 2005
2005 AAPPM/Codingline Spring
Practice Management Coding, Billing and
Reimbursement Seminar at the
Crystal Gateway Marriott 703-920-3230, Arlington,
VA.
I hope that you and your
staff will join us.
Bill McCann, DPM
President, AAPPM
*_*
*_* *_*
From: Shelly Bunting
re:
Billing for Acticoat* Dressings
Gayle,
I was checking to see if I
can ask a coding question. In the past our
office
has used code A6201 (Acticoat)
and had very little success getting it paid.
Our representative for
Johnson and Johnson has recently come in and said
we can
bill for Silver (code A6196
or A6197) and get paid. I tried to pull up the
archives at Codingline, but
there was nothing available on this topic.
We are
in South Carolina. Do
you know anything about this code?
Thanks,
Shelly
*_* Calendar *_*
Gayle,
In reference to the question
about a coding seminar in Chicago, APMA is
doing a coding seminar at the
Midwest Podiatry Conference on April 7
from 12:30pm-3:30pm.
Phill Ward, DPM
APMA Trustee
FootZine's Calendar page is
found at http://www.footzine.com/FZ_4.htm
*_* Networking *_*
Esther Espinoza is a
podiatric medical assistant who lives in
Silverdale [WA]
and is looking for a
full-time permanent position. She has worked
with me for
over one year in my former
practice in San Antonio, TX, and has moved here to
Washington with her husband.
She has worked front office and back office and
is very energetic and
friendly. If anyone in the Silverdale and
surrounding
area is looking to hire,
please contact Ms. Espinoza at 360-697-5726 or
myself
for more information.
Thank you.
John Hoy, DPM
Seattle, WA
206-682-8741
*_*
*_* *_*
Hello Gayle,
I live in Bergen County, NJ
and am searching for a full time position in a
podiatry office. I have
19 years experience in the field. For the
past 12
years I held the position of
Office Mgr in a two physician practice. My
expertise lies in billing and
collection in addition to developing and running
a smooth teamlike office
staff. I have had offers from other
physicians, but
if possible, would enjoy
staying with podiatry. I am proficient in
Medisoft
and Sammy as well as
internet, word, etc. Thank you for your
time.
Susan Doerner
suzyq1225@aol.com
201 391-4682
Notices of positions wanted
or positions available, as well as other
"classified"
information, are welcome. They are posted at the
FootZine web
site's Networking page. Have
a look at http://www.footzine.com/FZ_6.htm
*_* FootZine Feeture Article *_*
Crystal-Clear Coding Q &
A
The First Question (from
Volume 102):
Gayle,
Quick question, I had a
doctor who did an in hospital office visit.
We coded
it 99221 with a place of
service of 21. Medicare denied, can you give
us a
heads up on what code would
work better?
Thanks,
Alice
The Answer (Another
perspective from Dr. Horsman):
POS 21 is in-patient
hospital.
CPT 99221 is an initial
hospital examination by the ADMITTING physician.
All I
can guess is that the patient
might have already been admitted by someone else
(who billed Medicare for
that)....as such, perhaps they expect to see your
doctor bill as a consultant,
or using "subsequent hospital care"
codes, CPT
99231-99233.
Rick Horsman, DPM
Olympia, WA
*_* *_*
*_*
The Second Question:
Hi,
Does anyone have a suggestion
on what HCPC's code to use for a Bledsoe Boot
w/achilles, hi-top? We
used the suggested manufacturers code of L4386,
but
were barely reimbursed the
price we paid for the boot.
Thanks!
Patti
The Second Answer:
L4386 is the correct code for
the cast boot. Bledsoe does tend to be one
of
the more expensive cast boots
and one of the better ones but unfortunately you
will be reimbursed the same
as if you purchased one of the less expensive
ones.
Reimbursement for
Medicare is typically in the $120-130 range.
Scott Schroeder, DPM
Wenatchee, WA
*_* *_*
*_*
The Third Question:
Hi Gayle,
I would like to subscribe to
the FootZine. Please advice me the necessary
steps.
I also have a coding question
and seek your advice.
Can you bill an office visit
with the code 10061 and an office visit with code
11730 with modifier 25 for
E/M visit?
Thanks,
SG
The Third Answer:
If the patient is a new
patient this will typically be allowed due to the
work-up necessary to make the
decision for the procedure. The current
explanation in the 2005 CPT
manual is as follows: "The E/M service may be
prompted by the symptom or
condition for which the procedure and /or service
was provided. As such,
different diagnoses are not required for reporting
of
the E/M services on the same
date." However if a patient is there
for a follow
up visit and just comes in
and no significant work-up was performed and the
procedure was performed then
charging an E/M in combination would be
inappropriate.
Scott Schroeder, DPM
*_* *_*
*_*
The Fourth Question:
We use the product "ACCU-MOLD",
a moldable silicone compound, often in our
office. Is this item
billable to insurance carriers? If so, any
idea what the
HCPCS would be?
Thank you,
Cindy
The Fourth Answer:
It is my own opinion that
silicone moulds are not a covered benefit, and
that
they should either be
absorbed within the E/M of the office visit (if
you're a
REALLY nice guy... this is
expensive material), or charged to the patient.
Rick Horsman, DPM
*_* *_*
*_*
The Fifth Question:
Dear Ms. Johnson,
I am a new billing company.
I have been informed that CPT code L3020 will not
be used any longer. Is
this true, please help.
Thanks,
Becky Proffitt
Center for Primary Care
The Fifth Answer:
Regarding CPT/HCPCS codes for
orthoses.... it is my personal opinion that the
correct code is CPT L3000,
charged for each side. I haven't used L3020
in
years.
Harry Goldsmith is pursuing
the issue of clarifying CPT and HCPCS coding;
stripping out codes that have
no reason to be there, and only confuse the
issue. This would be
one of them.
Rick Horsman, DPM
*_* *_*
*_*
The Sixth Question:
Hey Gayle thanks for all the
great advice!!! I have a coding question
that
actually may be too long for
the email but maybe you could forward it to Dr.
Horsman or Dr. Schroeder.
You can give them my email address if needed.
I want to know if I am using
the correct code for the correction of hallux
limitus.
To cut it short---the op note
says an incision was made over the dorsum of the
first metatarsophalangeal
joint....metatarsal head was then exposed the
medial
eminence was removed....the
dorsal eminence was also transected (very
arthritic
with chronic
changes)....approximately 1 cm proximal to the
articular surface a
wedge of bone was cut from
the dorsum of the 1st metatarsal head.....screw
was
used to fixate the capital
fragment.......
Is 28289 the code I would
use?????
Thanks for any help!
Stacy
The Sixth Answer:
Terminology is awkward....
but this originally sounded like a cheilectomy,
....
but then added the
decompressional metatarsal osteotomy.
The cheilectomy (resection of
the prominent bone) would be incidental to the
metatarsal osteotomy.
This is a procedure which I commonly perform
myself.
Applicable coding.... CPT
28296
Rick Horsman, DPM
Crystal-Clear Coding tips are
posted on the FootZine web site on this page:
*_*
"Learning is a treasure
that will follow its owner everywhere."
- Chinese
Proverb
*_*
*_* *_*
*_*
Here's a fun web site from
the BBC that we found recently. Called
"Science -
Interactive Body", it's
a test (a sort of puzzle) of one's knowledge of
human
anatomy, with separate
"games" for Organs, Muscles, Skeleton
and Nervous
System. The screen
shows a single bone, for instance, and you
"drag and drop"
it to the appropriate place.
Each "game" includes several examples,
and the
bones (or organs, etc.) vary
from one round to the next. This
sophisticated
interface requires correct
orientation of the part as well as proper location
in order to score.
Correct answers sometimes prompt a quick
360-degree
animated view of the body
part (such as the calcaneus in relation to the
rest
of the foot). They
offer hints and tidbits of information about each
part
shown. Along with a
numeric score, the player is labeled
"competent",
"butcher" or
"capable", for example. Check it
out here:
Winter is officially over.
In between spring-time activities, feel free to
take a break and drop us a
line!
~ Gayle
*_* *_* *_*
Copyright 2005 Gayle S. Johnson. All Rights
Reserved.
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