Oh that’s actually really funny. I wonder if we bill like what they tell us and we get audited, can we use the PowerPoints or notes from this conference to defend ourselves?
Haha, I sure wish it worked that way.
Most of the coding seminars are basically just people (billers, docs, etc) who are saying what they think or what they have done recently. I have been to ones that were anywhere from good to terrible advice (AAPPM, ACFAS, consultants, webinars, etc). For coding advice, I basically take them all with an iceberg of salt. The most hilarious one I ever heard was a DPM's wife who was "head biller" for his
non-op solo PP, and she was giving lectures to groups, supergroups, etc on "the current standards for podiatry billing." It was crazy... no references whatsoever in the presentation, yet she was an authority on e/m levels, surgery, RFC... and everything else. I guess ya get what you pay for. 🙃
... clearly stated DO NOT do grafts everyone is getting the clawed back so not subject yourself to this money grab it is not worth it
For sure. That is a dry well that will only attract the wrong attention at this point.
And many of these same ppl who were "helping" to promote amnio codes just a few yeas ago.
I am so glad the 'amnio graft' BS party is over with and that gravy train is over with. Tons of PPs and hospital pods alike abused that stuff. It was a black eye on all of us.
Well they said bill both reduction of the lisfranc as well as ORIF/fusion....
Sure. Try it if you do the work. Why not?
I don't think the success rate will be too high, but you never know.
It depends on payers, but I can barely get fibula ORIF + syndesmosis ORIF to get paid most times (without a re-submit).
... apparently we are supposed to be doing an EM every 30 days for all wounds because you need to appropriately assess the wound healing plan...
Eh... I do E&M nearly every time.
I don't see how you can treat wounds without constant re-eval. These are sick ppl always teetering on re-ulcer or infection.
I know
@DYK343 and others above feel different, but I think any mgmt of deformity (DME, sx plan, etc) or mgmt of cellulitis (add/stop/change PO abx, labs, Wcx f/u, etc) or mgmt of PVD (comp, refer Vasc, testing, etc) is not directly related or included to debridement procedure for the wound. Obviously, people have two feet and the contralateral isn't typically A+ either. There are dozens of legit dx codes to put on the e/m which are unique from the L97.xxx code. Maybe I'm dumb, but it pays. Those pts are
bigtime time sucks and major staff use in PP... so you can't just get 11042 each week if you are doing much more than a scrape and bandage. These types of visits are depressing and rough work other docs don't want (I truly don't either); you have to try to get paid for what you do. Some payers will bounce the e/m or the wound code, but it can get re-submitted... and plenty do allow both on initial or re-submit/appeal.
I also break the global 90d on foot amps often (cellulitis, surgical dehisce/wound, biomech for DME, contralat limb issue, etc) as these patients very seldom have uneventful and trouble-free routine healing. Jmo
...You can bill for the post op shoe....
I'm not aware of a [payable] code for this.
L3260 would be the (described) code for post op velcro shoe, but MCR and all other payers reject it (since at least the time I was in pod school... maybe always have).
You could try 29540 / 29581 if you put an appropriate wrap/strap on with the shoe? (basically doing the wrap and billing it... and gifting the velcro shoe)
For any PP that I know, velcro post op shoe is either a cash pay thing or a gift to pt in need (no HCPS).
For my office, I do them for $10 usually (they cost me about $5 or $6), or I sometimes give them to ppl in need who I figure might be on hard times with money... or types who a charge might irritate them (just broke digit, just had amp, etc). The pre-op pts or pts progressing from CAM boot to surg shoe are usually happy to pay a nominal cost when you tell them insurance doesn't pay for it, though.
