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FootZine,
Volume 93 |
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Today I want to revisit a
question that has come up in past issues. I
have recently took part in a discussion about
various methods of instrument disinfection and
sterilization. Among the issues that came up
were whether the use of "cold
sterilization" solutions truly results in
sterile instruments, and whether there is a more
efficient and effective way to kill all organisms
that are of concern to us before we handle
instruments, such as in scrubbing them or packaging
them for the autoclave. Those questions led to
others such as how long it takes various solutions
to kill the different bacterial, viral and fungal
organisms; or whether instruments should be scrubbed
at all, or only processed in an ultra-sonic cleaner,
or maybe scrubbed after the ultra-sonic device has
loosened any debris. Should "routine
care" instruments be handled any differently
than surgical instruments? How are we dealing
with contaminated surfaces such as counters, tables
and floors? Are the cleaning solutions and
disinfecting wipes adequate? So I thought I would ask for input from all of you. If you will send me your procedures and protocols, I will share them here. If you have additional questions in this area, I will pass them along. We would be very interested to know what the greater podiatric community considers the standard these days. *_* *_* *_* Thanks to Mary Wasell for sending me the link to "Infection Control Today". There is both a print magazine (for a fee) and a free e-newsletter. It is a broad-ranging publication, and not all of it may be pertinent for our podiatric practices. Whether you have a surgery center, a designated operating room in the office, or any general concerns about infection control, it's nice to know where to find "The Voice of Authority in Infection Control". To subscribe, click the link below, and look in the column on the far right: http://www.infectioncontroltoday.com/subscribe.html ~ Gayle
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From: Sharonre: Collecting Co-Pays Hi: We should have a poll: How many patients in a month do you estimate you have that think they do not need to pay their co-pay again because "they paid it last time"? Then after explaining to them, politely, that their co-pay covers the office visit and is due at every visit...95% (assuming this is how their insurance works, which is how most of them DO work...) then pay it, but there is that 5% (or less) that call us thieves and walk out!! I'd say we have maybe 1 a month. The reason I ask for this poll is that we had a record of 3 [people] this WEEK who went ballistic when asked for their co-pay. (And we were in a correct position when asking for it.) Must be where the moon is this week.......?? (smile). Sharon San Antonio, TX *_* *_* *_* From: Becky Brackbill re: HIPAA Readiness and Translation to Spanish Dear Gayle, I am a PMAC with Dr. Eric Egelman. I would like to receive e-mail that will help me as the Privacy Officer. I attended the meeting in Harrisburg and have lots of things to do to be compliant in the final HIPAA phase. I need the Privacy Practices in Spanish. Can you help me find a copy that we can tailor to our office? I have a manual that Dr. Egelman got from the APMA. I would appreciate some help in constructing policies and procedures. Thank you, Becky Brackbill *_* "Try to learn something about everything and everything about something." - Thomas H. Huxley *_*
*_* FootZine
Feeture Article
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The Question:Crystal-Clear Coding Q & A by Rick Horsman, DPM, and Scott Schroeder, DPM Can a correction of hammertoe 28285 and saucerization 28124 be billed together for work on one toe? Thanks for any info.!!! S. Davis The Answer: I will answer relative to Medicare, which typically sets the highest (most strict) standard. No, you cannot bill both CPT 28285 and CPT 28124 on the same date, unless the services are provided on separate digits. If that were the case, use the digit-specific T modifiers to unbundle the CCI edit. Regardless of what you may do to a single digit in order to make it "good", most insurance plans will not pay more for any single digit than their allowance for CPT 28285. Rick Horsman, DPM Olympia, WA The Question: Can you please give me some clarification in regard to orthotics HCPCS L3010 and reimbursement from DMERC? Is this a reimbursable item and what are the diagnosis codes to get reimbursed for this item? I have spoken with DMERC but, I'm still a little confused. Thank you, Cindy The Answers: In response to Cindy's question: To my knowledge Medicare does not cover the code L3010 (foot insert, removable, molded to patient model). This would be the patient's responsibility. They will cover special types of insoles and shoes for Diabetics that meet certain criteria in the A5500-A5511 series of codes. Scott Schroeder, DPM Wenatchee, WA *_* *_* *_* Scott is correct. Medicare ONLY covers inserts (or orthotic devices) under the terms of the Diabetic Therapeutic Shoe program, and those service may only be billed via the A550x series. Any billing to Medicare using the L301x series will be promptly and summarily rejected. Rick Horsman, DPM The Question: Would like to know the codes to use when billing multiple injections on one foot and/or both feet for neuromas. Also how to bill for custom orthotics. Thank you, Gayle. Debbie McGovern (David McGovern, D.P.M.) The Answer: When billing multiple injections in one foot you should use the -59 modifier, ie- 20550 & 20550-59. If billing bilateral you can use the -50 modifier indicating it is a bilateral procedure, ie- 20550-50 and then increase the fee on this to 1 1/2-2 times your normal billed amount for one injection. You just have to have one line item that way. The other option with a bilateral injection is to bill it with the -59 modifier as above. I think Medicare at least in our area is trying to encourage the use of the -50 modifier. Certain insurance companies and Medicare in your area may only allow a certain number of injections per office visit. For custom orthotics the codes of L3000 or L3030 should be used. You would bill for each foot. For instance L3000 Left & L3000 Right. You would use the appropriate diagnosis code as the foot condition dictates. Some insurance companies cover them and others don't. If not, it would be the patient's responsibility and they should know this up front. L3000 (foot insert, removable, molded to patient model) is probably a more appropriate code than L3030 (foot insert, removable, formed to patient's foot) but I have found in our area some of the insurance companies are not recognizing L3000 as well and we have had some problems with it so we've been continuing to use the L3030 code. Reimbursement may be higher with one or the other. Scott Schroeder, DPM
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The majority of the FootZine
mail lately has been about coding concerns.
Thanks to those who write with their questions, and
thanks especially to Drs. Rick Horsman and Scott
Schroeder, who share their experiences and expertise
for the benefit of all the FootZine
subscribers.There will not be a FootZine broadcast next week, as we will be enjoying time with family and friends. I'll take this opportunity to wish you all a Happy Thanksgiving, and to express thanks to FootZine's subscribers and contributors. I look forward to hearing from you soon! ~ Gayle
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Copyright
2004 Gayle S. Johnson. All Rights Reserved. or click
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