Hello, I understand that in the CMS A52996 Routine Foot Care reference, the systemic ICDs with the asterisk (*) indicates that a managing provider and an approximate date last seen for the condition is required. I initially thought that the ones WITHOUT the asterisk, for example, I73.9 Peripheral vascular disease, unspecified, doesn't require those information; however, I'm starting to get denials and when my AR department called Novitas to get more information, they were told that a... Read more ..read more

Hello. We are new to billing Q4236 and are being told by the supplier that we are fine to bill this with the application of the skin graft 15275. Anthem is bundling the code though and I am curious if anyone has seen this. If so, what modifier are you using or is this correct and we should consider the skin graft part of the Q4236? Any suggestions or help would be greatly appreciated. Thanks ..read more

If a provider does callus debridement around a wound for an ulcer and the patient does not have neuropathy, do you append modifier GY or GZ? As we know we do not have a payable diagnosis. Thank you, Alicia, CPC ..read more

My surgeon did this procedure: Following thorough irrigation, all surgeons involved changed the outer layers of gloves and used sterile instrumentation from this point forward. At this time, it was noted that the FHL tendon was too diseased to leave intact and was excised at its most proximal accessible portion at the border of healthy and diseased tissue and resected at its most distal accessible portion at the border of healthy diseased tissue, FHL tendon portion was... Read more ..read more

Help needed for CPT code left ankle excision of osteophytes ..read more

The podiatrist we work for has recently started using Leneva allograft/adipose Matrix in patients feet for the replacement of inadequate tissue. The hospital bills for the Leneva and is getting paid. Our doc is using 11951 as the administration code and this is getting rejected by all insurances stating it is cosmetic. Is there a modifier that we should use, or a different code? This is a new product and it is working for the patients ..read more

PREOPERATIVE DIAGNOSIS: Left hallux ulceration, deep to subcutaneous tissue and a left second digit skin blister. POSTOPERATIVE DIAGNOSIS: Left hallux ulceration, deep to subcutaneous tissue and left second digit superficial abscess of the skin. PROCEDURE: Debridement of the left hallux ulceration with application of Clarix and incision and drainage of left second digit blister/abscess. OPERATIVE TECHNIQUE: The patient was placed in the supine position and prepped in the usual aseptic... Read more ..read more

Limitations for trigger point injections how many can the physician can give for each encounter. Having trouble with UHC and BC CA. Would a modifier be appropriate? I'm also getting 20551 denials for global period ..read more

Is an injection of B12 to a nerve considered a "nerve block"? And would you code this injection as 64455? Nerve Block: Injected vitamin B12 1000 mcg to the proximal fifth digit, 10th proper plantar digital nerve course and sural nerve region where lesion of plantar nerve is palpated, between the lateral ankle ligament repair and coursing to the plantar lateral fifth metatarsal base fracture repair sites where painfully palpated, R. Any other suggestions? Thanks ..read more

Looking for Podiatry coding help. The patient previously had a transmetatarsal amputation and returned to OR due to progressive necrosis and I am unsure what cpt code would be best. Excerpt from the op report: Attention was directed to the open portion of right foot transmetatarsal amputation. Quick inspection was conducted and noted progressed necrosis from previous inpatient hospital encounters, with exposed metatarsal bones 1 through 5 which were dusky devitalized discolored... Read more ..read more