There is valid and chronic concern about the cost to Medicare regarding the complications of falling. I have heard from the experts that the cost to taxpayer annually is $50 billion. The podiatry profession is of one the first lines of defense when it comes to assessing patients for fall risk. There is also an incentive to abide by the MIPS quality measure for assessing fall risk for any patient 65 year or older. There are companies that provide the STEADI questionnaire available in software programs that can be used in the office along with balance assessment. There isa CPT code that can be used, 97750 (15 min/unit will max MUE of 8 units) for the purposes of billing. I was just wondering how many times this code can be billed per annum on a particular patient that is being assessed for fall risk? Since patients are usually seen multiple times throughout the year in a podiatry office for foot care and their health/medications/etc. can change during the interim between visits which could increase their fall risk score. So, would be appropriate to evaluate these patients every visit and bill for the 97750 if all the required billing parameters are met?
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The first question to answer is why this needs to be repeated at any frequency? If after your first encounter performing this service, you did nothing, then one should ask why the patient needs another evaluation within the time frequency you are dealing with. If the patient was referred for OT and PT because they were a fall hazard and were additionally prescribed an Ambulatory Assistive Device (AAD), then monitoring the patient's improvement and issuing additional referrals for additional PT and OT would certainly translate to billing this PT service again.
What this boils down to are two words: Medical Necessity.
Why does the patient need this service? Performing this under MIPS may only avoid a penalty and may be done as a screening tool. Performing it in order to gain reimbursement are not the same. For the former you don't require medical necessity for the latter you do.