I recently read a bulletin from a state association coding advisory column which posed this question: I am not a DMEPOS provider and want to submit a claim for foot orthotics to the patient's secondary. I have no intention of becoming a Medicare DMEPOS provider. What should I do? The answer seemed incorrect based on my experience. The response from the coding advisor was to simply amend the GY modifier. Is this correct? If not correct what is the correct answer?

Please provided guidance or confirmation on the appropriate CPT codes when applying a biological wound skin graft substitute. I understand when this type of skin substitute graft is applied in the office that the appropriate HCPCS code for the graft and the number of units based on the brand name and size must be billed. Then, I understand that CPT code for application of a skin substitute graft: 15271-78 categorized by wound graft size and anatomical site. But should the CPT code 15002-15005 which describe the work of preparing a clean and viable wound surface for placement of the graft as well? Also, can you bill the CPT codes 97597-95798 or 11042-11047 on the same day the graft is applied which indicate debridement of the wound? And finally, what about billing for the E/M code 99212-99215?

A new wrinkle from BCBS of GA. They are denying E&M visits with Diagnosis G57.61 or G57.62 stating the diagnosis is inconsistent with the procedure. There was no procedure done, only a follow up visit ( 99212). Prior service was an IOV with xrays 3 3 weeks prior for one patient , the other patient had a corticosteroid injection 3 weeks prior . Any thoughts?