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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: http://apma.org/s_apma/doc.asp?CID=18&DID=17913 ~ Gayle *_* "I am a slow walker, but I never walk backwards." - Abraham Lincoln *_*
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Letters *_*
From: Robert C. Taylorre: 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: http://www.marlowwhite.com/cgi-bin/shopper.cgi?preadd=action&key=65-100 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
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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
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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 *_*
The First Question (from
Volume 102):Crystal-Clear Coding Q & A by Rick Horsman, DPM, and Scott Schroeder, DPM 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: http://www.footzine.com/FZ_C.htm *_* "Learning is a treasure that will follow its owner everywhere." - Chinese Proverb *_*
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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:http://www.bbc.co.uk/science/humanbody/body/interactives/3djigsaw_02/index.shtml Winter is officially over. In between spring-time activities, feel free to take a break and drop us a line!
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Copyright
2005 Gayle S. Johnson. All Rights Reserved.
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