ANSWER: If the podiatrists/provider reviewed the medical policy on the MA site and it is stated they do not pay, then it is not covered. If performing an E/M at the time then bill E/M. It is alright to create your own code for cosmetic nail care, practices do this and the patient pays. It is fine to call it a “medical pedicure service”, meaning you the medical provider are doing the cosmetic service and I would bet most plans do not cover cosmetic services. Again, each MA plan has rules, see what they say about cosmetic services.
Can you tell me what is best to do?
ANSWER: If the podiatrists/provider reviewed the medical policy on the MA site and it is stated they do not pay, then it is not covered. If performing an E/M at the time then bill E/M. It is alright to create your own code for cosmetic nail care, practices do this and the patient pays. It is fine to call it a “medical pedicure service”, meaning you the medical provider are doing the cosmetic service and I would bet most plans do not cover cosmetic services. Again, each MA plan has rules, see what they say about cosmetic services.