You say ... patient has diabetes ,hypertension., patient now has an ulcer on their toe. Now patient has a new diagnosis of diabetes with ulcer.
I'd say this is definitely a new problem, so I'd go with direct billing. The physician can't have formulated a plan of treatment for a problem that didn't exist before. (i.e. the ulcer).
Just my opinion.
F Tessa Bartels, CPC, CEMC
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