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THE DOCTOR LINE
256 items found for ""
- AFO documentation requirementsIn DME Coding·23 de octubre de 2024Had a post payment review last year, recouping reimbursement on a $700 Arizona AFO of a diabetic with severe ankle DJD. Have the same scenario now. What documentation, hoops do I have to jump through with documentation to satisfy the Gods and avoid a repayment demand for a similar AFO?1424
- Mock AuditIn General News9 de octubre de 2024Dear Sarah, we do audits as a consultant as does my partners in thedoctorline.com . Audits are either targeted or random and we can select various aspects in a practice to review. A consulting agreement is made with one of us. My consulting email is djfreedman@cpmapro.com. Dr. Bass email is alan@parecomplianceservices.com Dr. Kesselman email is paul@parecomplianceservices.com.11
- orthotic overhaulIn DME Coding·19 de diciembre de 2024My Medicare patient requires a custom foot orthotic overhaul. I noticed that there is a labor and expense code and misc parts HCPCS codes for this service. Does this mean that Medicare will cover this, even though they won't cover the orthotic itself? That seems a bit crazy?035
- FDA Registered products only?In DME Coding·20 de diciembre de 2024Is it true that Medicare (and perhaps other third party payers) will only pay for products which are FDA registered? How do I find out if a DMEPOS product is FDA registered?011
- Not in host state for plan and in my state no coverageIn DME Coding·20 de diciembre de 2024I have a patient who lives in an adjacent state where the law states if there is medical necessity the insurer has to cover the service. My issue is that there is no such law in my state and foot orthotics are not a guaranteed coverage item in my state of NY. Is the patient still responsible for coverage or is the insurer?013
- Is there a new Skin Substitutes Medicare Policy Effective 2/12/2025?In Wound Care Coding20 de diciembre de 2024Does this new LCD apply to all MACs as NGS has not had an LCD on CTP for years. Also does this LCD apply to non diabetic and non VLU? For example non diabetic ischemic wounds, or non diabetic immunocompromised wounds (chemo or RA patients on Biologics) who wounds won't close with SWC?01
- I have been told that Medicare can recoup money if the device is not validated by one of their agencies? Is this true?In DME Coding·20 de diciembre de 2024012
- Enrollment in DMEIn DME Coding·20 de diciembre de 2024I am having difficulty with my DME enrollment and have been told I could have listed By Appointment Only. What should I do?014
- Can a staff member dispense and fit any DME in my office if I am on the premises?In DME Coding·19 de diciembre de 2024A question came up recently, as a podiatrist, I delegate work that my medical assistant does to help me be more efficient in my daily practice. Can the medical assistant dispense and fit any DME in my office if I am on the premises?014
- Nail avulsions bilaterally, what is proper way to bill for hallux bilaterally?In Surgical Coding·19 de diciembre de 2024The doctor performed bilateral hallux nail avulsions, at first the doctor wanted to bill it as CPT 11730-TA and CPT 11730-T5-59, but this does not seem right, can you assist me in billing this correctly? This patient never had a problem before, so this case it is not a repeat nail avulsion issue.013
- If I grind toenails what is the correct way to code them?In Routine Footcare·19 de diciembre de 2024If I grind toenails, I have been told to use HCPCS Code G0127 but also CPT 11720 or CPT 11721 when I grind toenails, what is the correct procedure code(s)?012
- I am performing heel surgery to remove a Haglunds deformity, what is the correct CPT Code?In Surgical Coding·19 de diciembre de 2024Calcaneal surgery for Haglunds deformity, what is the correct CPT Code to use? I see different options like CPT 28118, 28119, and 28120?014
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