The American Academy of Podiatric Practice Management (AAPPM) exists for the sharing of practice management ideas and information between its members, with the goal of helping all succeed.  AAPPM President Hal Ornstein has passed along a member request for examples of patient recall letters.  There are certainly many variations on that idea, and I will be happy to share any samples you send to FootZine.

There has been very little meeting information for our Calendar lately.  If your organization has a program for podiatric assistants planned, please let us know so that we can pass the information on to our FootZine readers. 

Thanks !

 ~Gayle

From:  Sharon Hockinson
re:       "Shoe Buddies"

Gayle:

Do you or your readers know of any web sites for shoe buddies? I guess that's what it's called - it is for people who can go into purchases of shoes together who have different foot sizes and can share the expensive burden of buying two pairs of shoes.

Thanks,
Sharon Hockinson
San Antonio, TX

Highly motivated, patient-focused Podiatric Medical Assistant seeking a position in the Seattle, WA, area where I can contribute my skills and experience to be an effective team member in an environment that mixes challenges and learning opportunities for professional and personal growth. 

Contact:  Gayle S. Johnson
gaylejohnson@footzine.com
(206) 440-0137

*_*    *_*    *_*

Gayle,

I thought you may be interested in knowing about my new site.

Podiatryzone www.podiatryzone.com is a dynamic new website dedicated to
meeting the needs of Podiatrists and employers of Podiatry 
professionals.

As part of our launch promotion all Employers are invited to trial
www.podiatryzone.com free.

Regards,

Paul Dunn
sales@podiatryzone.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

The Question:

Hi Gayle,
I want to tell you how invaluable FootZine is. My husband and I truly value what you're doing.

Question: Is it necessary to use Q modifiers when billing for an initial or ongoing convalescent hospital or office visit?

Thanks again for your help.

Kate Prado
Dr. Mike Prado


The Answer:

Q modifiers ONLY have relevance if you are providing routine foot care services upon a patient with applicable risk factors (non-traumatic amputation-Q7; absent pulses-Q8; softer vascular or neurologic signs-Q9).

This is true without regard to site of service, or whether it is for a new or established patient.

If it's not routine foot, don't you DARE use a Q modifier!  Bill it as applicable E/M and/or procedural codes.

Once you use the Q modifier, you have defined your services as routine, and are subject to all the restrictive criteria, documentation requirements, etc.

Rick Horsman DPM
Olympia, WA

The Question:

Hello Again Gayle,

One more question.  I see where a colleague of mine billed in this manner for a Medicare patient:

1. 99212  modifier 25
2. 11056  (can you tell me what this is?)  I think it might be debridement of nails 1-5
3. 11721  I think this might be debridement of nails 1-6

Is this within Medicare guidelines?  My colleague bills for subsequent visits on this same patient:
1. 11056 Q8
2. 11721 Q8

Is this ok?  Thanks for your help.  Have a great long week end.

Kate Prado
Dr. Mike Prado

The Answer:

It is suggested that you review your CPT manual regarding these codes, as these are fundamental, and very commonly used codes.

CPT 99212 is a minimal office visit for an established patient. The 25 modifier indicates that the provider provided some procedural services on the same visit/date of service.

CPT 11056 is trimming of several hyperkeratotic skin lesions. These might be corns, or....
 
CPT 11721 is debridement of 6 or more dystrophic and/or symptomatic nails (depending upon criteria established by the carrier)

When these codes are all used together, correct coding is:
99212-25
11721-59
11056

If they are arguing that this patient warrants these services based upon absent pulses (which is what the Q8 modifier is suggesting).... correct coding is:
99212-25
11721-59-Q8
11056-Q8

Since these are such fundamental and frequent issues, I suggest you review your Medicare carrier's LMRP on routine foot care, as they may have carrier-specific criteria for coverage, documentation, and coding.

Rick Horsman, DPM
Olympia, WA


Coding Questions and answers will continue to be posted on the FootZine web site on this page: http://www.footzine.com/FZ_C.htm

Ever notice how when you're feeling kind of melted and wilty, so is the chocolate in the cupboard?  Still, it's hard to complain about the sunshine and daylight that lingers long after dinner-time.   When you're hiding out from the heat, feel free to write!

  ~ Gayle

Copyright 2004 Gayle S. Johnson.  All Rights Reserved.
DISCLAIMER: Acceptance and publication of any letter, article, news item or advertisement does not necessarily constitute or imply approval or endorsement by myself of the product, idea, or content therein. I reserve the right to edit or to not publish any material received. Any letters published are the property of FootZine. Any health- or legal- and financial- related information is for educational purposes only and should not be construed as medical, legal or financial advice, or a substitute for the advice of a healthcare professional, attorney, financial advisor or any other consultant or professional. Information pertaining to legal matters should not perceived as legal advice, nor should discussion about such issues as Medicare, coding, and billing be considered as definitive. All content is presented as being only the opinions of the contributors and is for educational purposes only.

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