FootZine Page 805

The delay in publication of this issue has made me late in acknowledging the accomplishments of two pioneers in podiatric internet publishing.

On April 10, 2005, PRESENT Courseware completed 3 days of lectures in Madrid to 150 podologists from all over Spain, introducing their Spanish-translated PRESENT lectures to the Spanish-language podology market. By all accounts this development was received with great enthusiasm by those attending. Congratulations, and muchas gracias, to Drs. Alan Sherman and Michael Shore for their foresight in expanding the offerings from PRESENT Courseware.

The May 14, 2005, issue of PM News, Number 2276, marked the tenth anniversary of that publication's formal introduction. Begun in 1992, PM News is now the largest listserv for the podiatric community, with thousands of subscribers around the world. Congratulations to founder and editor Barry Block, DPM, JD, on reaching this major milestone. We wish him and PM News continued success, and feel privileged to have him on the FootZine Advisory Board.

~ Gayle

*_* Letters *_*

From: Linda Harr
Re:     Place of Service Coding

Hi Gayle,

I have a question I would like to present. I am trying to obtain the most accurate place of service code for the following scenario.

Patients are seen at a senior citizen activity center for podiatric care, however these patients are still living in their own homes. What is the correct code to use for the place of service?

Thanks again for your help!

Linda Harr, Secretary
MPMAA

*_*    *_*    *_*

From: Gail Bennett
re:      HIPAA Compliance

I missed the HIPAA Compliance Inspection portion of our seminar [WSPMAA, April 9, 2005] and am wondering about the 20 questions that were asked by Garry Stutz. Can someone fill me in: Such as number 6, 7, actually just about all of the numbers. Did he tend to agree with what Kevin West lectured on a few years ago? I believe we have a HIPAA manual that Kevin West helped to make.

Anyone that was in that lecture that could give me insights please call me:
(509) 838-2929

Gail Bennett
Spokane, WA

*_*    *_*    *_*

From: Sharon Hockinson, PMRT
Re:     SS# Privacy Concerns (Volume 105)

My reply to Denise Nolan re: SSN.

We collect the SSN if the patient is willing to give it out; if they are not willing to give it to us, we do not ask them for it. The only reason we need the SSN is if their particular insurance company still uses it as their member id number. Some still do (if I remember correctly I think Benefit Planners is one, and possibly Great West). They do not print the number on the ID card, but ask that we obtain the SSN from the patient in order to bill and verify benefits. This is the only reason I can think of that we need the SSN.

PS: I forgot to include that Medicare (obviously) uses the SSN but I think that goes without saying.

Sharon Hockinson, PMRT
Podiatry Clinics
San Antonio, TX

*_*    *_*    *_*

From: John Clarke, DPM
Re:     IT Hires and Feedback on Digital X-Ray Systems

Hello Gayle,

Another excellent issue. I just finished reading the winter issue of the AAPPM News, then got your email. I was wondering if anyone has hired an information technology person as Ray Posa has suggested? Also, perhaps there could be some feedback regarding digital x-ray systems from both the Docs and their assistants.

Thanks again.

John Clarke, DPM
Fremont, OH.

*_*    *_*    *_*

From: Edith Szorc, PMAC
re:      Night Splints

Dear Gayle,

Regarding the night splint, the following is some information that we have received recently from the APMA. I hope this is a little helpful.

*_* Editor's Note: Edith referenced the APMA Daily eNews No. 1,830, dated May 6, 2005. I do not have permission to reproduce that bulletin; however, APMA members can access the archive of the APMA Daily eNews at this link: http://www.apma.org/s_apma/member.asp *_*

Edith Szorc, PMAC
from Chicago

*_*    *_*    *_*

From: Deb Siverhus
re:      Podiatric Dictionary

Good afternoon,

Many years ago I purchased a podiatric dictionary, by Peggy Kane... do you know where I might get a new one?

Thanks,
Deb

Deb Siverhus

*_* Networking *_*

Positions Available

Correction to this previous listing:

Medical Assistant. Front Desk Position.
1-2 Yrs. experience preferred.
Location: Southwest Michigan.

Contact Mary @ 269-651-1038
MCCLAINJMRS@AOL.COM

For Sale

Hi Gayle,

I have two pieces of equipment for sale in the Portland, Oregon, area that I would like listed on your site.

The podiatry chair is a MTI 530 Quad Power Chair with an articulated head rest, removable side arms, programmable positions and a duplex outlet. Color is a light blue/slate with a matching MTI SG Stool, selling for $6700. This chair could also be used by orthopedics and plastic surgeons. Pictures of this equipment are available in the Universal Foot Care Products Catalogue.

The Min X-ray Orthoposer is selling for $265. All equipment is 6 months old.

Thanks for your help in selling these items.

John Hahn,DPM,ND
Phone: 503-465-6951
cell#: 541-390-6951.
JMHAHN@aol.com

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
by Rick Horsman, DPM, and Scott Schroeder, DPM

The First Question: (from Volume 105)

Also can you give me the criteria for the code, 11755. I have someone
asking.

Thanks so much,

Deb

The First Answer:

This code is to be used if there is a suspicious lesion associated with the nail unit and the doctor wants to take a biopsy. This includes the nail plate, bed, matrix, hyponychium (skin at/under the end of the nail), as well as proximal and lateral nail folds.

Scott Schroeder, DPM
Wenatchee, WA

The Second Question: (from Volume 105)

Hi,

Could you please give me the correct code to use for a night splint, we are a little confused, were told to use L1930 or L4396

Thank you,

Renee

The Second Answer:

L4396 is the more appropriate code for a night splint.

Scott Schroeder, DPM

The Third Question:

Gayle,

When billing for L3000 is it required that you bill for both right and left foot every time?
I know this may sound crazy but what about an amputee of one foot?

Thanks,

Jenny Wood
Executive Vice President
Wood Medical Billing Medical Professional Resources

The Third Answer:

You would only bill L3000 for those services actually provided.

First, it must be a custom made orthosis fabricated from a cast of the patient's foot/feet. The code is used once for each device so dispensed.

If BOTH feet are casted and supplied with an orthosis...billing is L3000 LT and L3000 RT. That it preferable over the "bilateral" modifiers.

If the patient is a unilateral amputee (absent right leg, for example) coding is L3000 LT.

Rick Horsman, DPM
Olympia, WA

Another Third Answer:

L3000 is billed per foot. So, yes it can be billed alone, just designate which foot.

Scott Schroeder, DPM

The Fourth Question:

The Dr. I work for is frustrated that PA Medicare reimburses so little for 97032 and wants to know what the CPT code is for the leads and how to bill for it.

Holly

The Fourth Answer:

Let me preface my remarks by stating that this is not a service I provide. Correspondingly, I might be "wrong".

With that stated, a few points.... all relative to Medicare; policies may well be totally different for other payers.

All providers are held to the same standard as a certified physical therapist: a written plan, goals, expectations, etc.

Medicare is rapidly (as we speak) demanding that these services must be provided by either a certified physical therapist (not a therapy assistant, office assistant, water boy, groundskeeper), or the physician him or herself. No one else can provide any of this care and have it reimbursed by Medicare

This is a "hands on" service... not the same as sticking the patient in a whirlpool while you go out for a coffee and danish, and keep the meter running.

I am not aware of any disposable/reimbursable supplies for this modality. To my understanding, there is no reimbursement associated with this other than CPT 97032 itself

The bottom line; you're not going to get rich off of this code, and Medicare is tightening up the criteria for those clinical indications they will reimburse it, and who must provide it, and how and how often and how many times it is provided.

In my own office, this would be a loss-leader, and I would refer it out to a physical therapist, and move on to other services with other patients.

Just my opinion.... and don't forget my disclaimer at the beginning

Rick Horsman, DPM

Another Fourth Answer:

I checked with our physical therapy friends and for electrical stim the electrical leads are included in the service and are not reimbursable separately. They are using the code 97014 for their electrical stim. You may want try this code to see if the reimbursement is any better.

Scott Schroeder, DPM

The Fifth Question: (Compiled from two separate inquiries)

Gayle,

Is it true that Medicaid and Ca Resource do not accept G0127 as a valid code?
Can we bill 11040 and G0127 together. And if so what modifier should we use?

Also G0127 is not accepted by Medicaid. This is a problem with Medicaid secondary especially. Since Medicaid will not consider coinsurance this is a write off!?

Thanks for your help!

Jenny Wood

The Fifth Answer:

I do not know if Medicaid or Ca Resource accepts GO127 as a valid code. I would not think so since this was developed by Medicare for its purposes. Dr. Horsman will have better insight into GO127 than I would. I have not ever used this code since there are better codes out there.

Scott Schroeder, DPM

Crystal-Clear Coding tips are posted on the FootZine web site on this page:
http://www.footzine.com/FZ_C.htm

*_*

"Things turn out best for the people who make the best of the way things turn out."
- John Wooden

*_*

Thanks to all who wrote in concern for our well being. It is in fact my husband who was seriously injured in April, but he is recovering nicely. As the weeks pass we are slowly finding our way to back to our old routine and with continued progress, we hope over the next few months to be back to normal.

We appreciate your patience as we have coped with this, as well as the recent passing of my mother.

Please do continue to participate with letters, either questions or comments. We would really like that.

~ Gayle