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Do any doctors have any thoughts on Extracorporeal Shockwave therapy ESWT with regards to whether it is covered by traditional Medicare? If answer could relate to New Jersey Medicare, this would be helpful. If covered, what diagnosis codes and procedure codes are used. Also, are there requirements for alternative treatments to be tried first and to fail before Medicare will cover the ESWT. Or, is this a strictly cash payment and not covered by Medicare at all?

I have a non union of a 2nd met and plan on taking a graft from the calc. Code please?

Had 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?

I am confused about the proper codes to be used for treatment of warts. If a patient comes in for an initial visit and I diagnose them with a wart and debride the wart and then apply salicylic acid under occlusion can I bill a new patient EM code and then 17110?   When they return for follow-up am I allowed to bill 17110 again if I debride the lesion and apply salicylic acid once again? The definition of the code 17110 includes the term chemosurgery but I am not sure if salicylic acid is included as it is keratolytic. I have always billed EM codes but recently I was told that was incorrect.

Queries: Rejected Claims for Medicare DME to Novitas Solutions  Has anyone had recent issues with rejections of claims for DME products (i.e. L4360 CAM walker)  We have been submitting these claims with laterality and KX modifiers, now out of nowhere they are rejected saying invalid information as specified in status details . We have tried new modifier combos, just -RT or-LT, just- KX, added -NU, none work . We called them and they said modifiers are incorrect but would not tell us what to use since that info is locked up with the nuclear codes. If something has changed they never informed us.  Anyone else with the same issue or any suggestion appreciated.  Larry Goldstein, DPM,  Warner Robins, GA

A diabetic patient is referred to me for an evaluation by her PCP. The patient has no complaints other than that. Is this a billing service under Medicare if they have no complaints?

What is meant by a front-end rejection by my DME carrier (CGS)?

Not an everyday event - but I removed a toe ring that was stuck. There was no vascular or soft tissue damage. I found a code for ring removal for the finger. I would think that the finger code would not be appropriate.  Jeffrie C. Leibovitz, D.P.M.

There is valid and chronic concern about the cost to Medicare regarding the complications of falling. I have heard from the experts that the cost to taxpayer annually is $50 billion. The podiatry profession is of one the first lines of defense when it comes to assessing patients for fall risk. There is also an incentive to abide by the MIPS quality measure for assessing fall risk for any patient 65 year or older. There are companies that provide the STEADI questionnaire available in software programs that can be used in the office along with balance assessment. There isa CPT code that can be used, 97750 (15 min/unit will max MUE of 8 units) for the purposes of billing. I was just wondering how many times this code can be billed per annum on a particular patient that is being assessed for fall risk? Since patients are usually seen multiple times throughout the year in a podiatry office for foot care and their health/medications/etc. can change during the interim between visits which could increase their fall risk score. So, would be appropriate to evaluate these patients every visit and bill for the 97750 if all the required billing parameters are met?

I recently failed a surgical dressing TPE because my charts did not document the depth of the wound. I thought that ingrown toenails and warts would do well with special dressings. Your thoughts?