1. A

    Wiki 11730 (nail avulsion) vs 11750 (matrixectomy) STILL CONFUSED (jump to procedure note example at the bottom for a quicker read)

    Hi everyone, I've been coding podiatry for 3 years and remain confused about the difference in the language between these two procedures. I have watched YouTube videos from 5 different channels demonstrating these procedures--though some of the videos labeled as "nail avulsions" use phenol at...
  2. J

    Wiki Affinity Measurements

    Good morning! I am new to Podiatry coding, and have a question about how to code the Affinity membranes. I am trying to figure this out by going back and looking at previous coders work. INITIAL WOUND: 2/15 is 3 x 4 x .2 cm THIS VISIT: 4/26 wound size is 1.2 x .5 x .2 cm The only...
  3. P

    Wiki 97597 and 97610 performed in home

    Please help me find information as to the coding rules for these "sometimes" therapy codes as related to treatment provided by an MD or FNP NOT employed by the home health agency. The two codes are being denied, the diagnosis codes are not the issue. POS is 12. Patients are being followed by...
  4. T

    Wiki Multiple 64455 denied by Medicare.

    Hello, I have a claim that we billed out an office visit 99213 25, injection J1030 , and 64455 on 4 lines with different toe modifiers and a two lines had mod 59. All 4 lines are denying for missing procedure modifier. Can any one tell me what I am doing wrong? I have been researching like crazy...
  5. N

    Wiki Flat Foot - Congenital vs Acquired -

    My provider is treating a dancer who has pes planovalgus. She coded as acquired, but I queried her because her documentation does not state a cause for acquired flat foot. She does not state in her documentation acquired or congenital, and she does not document "this is what caused the flat...
  6. W

    Wiki 28003/28005 with 28120, 28122, 28222, etc

    I am new to podiatry coding. There is a physician billing 28003 and 28005 (which are NCCI bundled with the following)... 28122, 28062, 28222, 28120.... Mostly diabetic foot infection procedures for debridement/incision and drainage. Is it appropriate to bill the incision portion of the...
  7. J

    Wiki Bilateral Congenital Pes Planus- Podiatry

    Our podiatrist has been dx alot of Q66.51 and Q66.52 lately. Ins specifically BCBS is denying OV with these two dx codes. They say it is against ICD 10 guidelines. They also said we can bill one or the other not both. There isn't a specific bilateral ICD 10 code. Has anyone else come across this...
  8. D

    Wiki BMA for injection

    I have several different physicians in different states that I bill surgical claims for that use bone marrow aspirate during surgery (mostly podiatry). Recently I've had denials for use of 38220 indicating 'payment is denied when performed/billed by this type of provider'. I then realized -...
  9. D

    Wiki 28470

    Provider billed 28470 diagnosis: M84.374A After appealing with chart notes, UHC says that the chart notes do not support that the 28470 was preformed. Dispensal of pneumatic cam walker was documented and diagnostics were preformed to accurately diagnose the fracture. The initiation...
  10. D

    Wiki 28470 not preformed

    Provider billed 28470x2 diagnosis: M84.374A After appealing with chart notes, UHC says that the chart notes do not support that the 28470 was preformed. Dispensal of pneumatic cam walker was documented and diagnostics were preformed to accurately diagnose the fracture. All of this information...
  11. D

    Wiki Pilon vs Trimalleolar Fx

    Good morning! I need some help in deciding if this is a Pilon Fx-27828- and ankle dislocation with IF-27848- (per what the doctor is requesting) or if this should be coded as a trimalleolar ORIF. I've gone back and forth with this any help or advice will be appreciate....below is the OP note...
  12. M

    Wiki Code for overgrown toenails

    I'm having trouble figuring out what code to use for the diagnosis of "overgrown toenails". There doesn't seem to be a specific code for that, the closest thing I can find is L60.8, other nail disorders. Is this correct?
  13. C

    Wiki Coding education in Podiatry?

    Where do all of you go for Podiatry coding references and education?? What coding companion books do you use as well?? Any advice would be helpful! Thanks! ilona
  14. S

    Wiki Routine Foot Care Question

    Hey all, I have a question regarding routine foot care. If we have a patient who has both nondystrophic nails and dystrophic nails, are we allowed to bill the CPT codes 11719 and 11920 on the same visit if we trimmed both type of nails? What modifier would you use in this case? From, Stephanie
  15. J

    Wiki URGENT: Podiatry Coder Needed

    Aviacode is in URGENT need of IP/OP remote multi-specialty pro-fee coder that is an expert in PODIATRY coding (part-time). DOMESTIC coders only. Please see details of project and how to log your experience HERE: https://goo.gl/K8MLoH
  16. A

    Wiki Billing Q codes with multiple units

    What are the maximum amount of units payable for Q codes (example: Q4045) by insurance companies? When my doctor puts a splint on a patient, our billing department is trying to bill multiple units of supply Q codes to one splint application code for reimbursement. For example: Dr. places a...
  17. M

    Wiki Class B findings podiatry

    I've read a lot of forums on the Class B finding but im seeing mixed answers on this. I have a new provider who said it has to be 2 of the 4 for pulses. So she wanted to do Posterior pulses absent bilaterally. Which makes sense to me. Do others agree with this. I've read a lot on it and to...
  18. J

    Wiki 11721

    I work for an FQHC in California we keep getting denials from one of our payers; when our billers bill 11721 with 1105, 11056 or 11057. Claims state that 11721 is not separately payable, that a modifier is needed and that 11055-11057 are exclusive when billed with 11721. I am so confused...
  19. J

    Wiki Midfoot Amputation

    Is 28800 or 28805 the right code for midfoot amputation? OP note attached
  20. D

    Wiki Arthrex Interna Brace reconstruction for pes plano valgus deformity

    New to podiatry coding (25 year+ Ortho background) struggling with (among other things!): Medial displacement osteotomy os calcis - (confident) 28300 Debridement posterior tibial tendon tear Tranfer flexor digitorum longus to navicular (confident) 27691 Reconstruction spring ligament...
  21. B

    Wiki Podiatrist billing Medi-cal California

    I need help I am working for a Podiatrist that is seeing medi-cal pts for 11720 or 11721 and we can't get paid we first billed B35.1 which is needs to be a secondary code per Medi-cal guidelines so I rebilled claim with L60.3 and B35.1 as secondary and we are still getting denied. We have the...
  22. S

    Wiki PLEASE HELP - Pre and post debridement measurements with callus

    I have providers in a podiatry clinic who are documenting 0 x 0 x 0 sq cm as the pre-debridement measurements when a callus is overlying an ulcer and then they document the size of the underlying ulcer post-debridement. They state that they cannot measure the wound before the debridement, since...
  23. M

    Wiki Muscle Repair of the foot

    Hello, I code primarily hand surgeries, but we get the occasional foot. And the difference in CPT codes is astounding! One of our surgeons performed an ORIF of the Calcanus and metatarsals. He also repaired the foot muscles. I don't see any codes for repair of the muscles, just tendons and...
  24. J

    Wiki Sesamoiditis injection

    I have a provider who gave a patient an injection for sesamoiditis. 20552 is coming back denied for medical necessity. Any ideas about what the appropriate code should be? I thought about 20600 or 20551.
  25. K

    Wiki Does partnership pay 11719

    Does Partnership EVER pay for 11719? Is it constantly denied because it's considered routine? I keep getting denials with all different DX and I'm new to podiatry so I'm trying to navigate through all the guidelines.....HELP
  26. D

    Wiki Humana and DMEs

    Please help. My podiatry practice bills out for DME products such as post-op shoes and pneumatic walkers. Humana has lately been denying them for incorrect modifiers. We have used LT, RT, Medicare modifiers, any modifiers we can find to try to get these paid for. Has anyone else had this...
  27. D

    Wiki Foot/Ankle Seminars

    I am looking for any foot & ankle seminars in the Phoenix area (or southern AZ) to attend. Anyone know of any? It should cover coding, anatomy etc Thanks! :cool: